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1/27/26 Go-Live Wednesday, January 28: Fixed-Dose KCentra for Emergent Anticoagulant Reversal

January 27, 2026

Pharmacy Team,

We will be going live on Wednesday, January 28 with updates to the HOSP Emergent Reversal of Oral Anticoagulants PowerPlan, transitioning from variable FEIBA dosing to a fixed-dose KCentra strategy for emergent anticoagulant reversal.

What Is Changing

KCentra

KCentra (4-factor PCC) will be the preferred agent for emergent reversal of:

• Warfarin-associated major bleeding
• Factor Xa inhibitor–associated major bleeding

Dose: 2,000 units IV x 1

FEIBA

• Reclassified as a non-preferred alternative when KCentra is contraindicated, such as known or suspected HIT
• Remains the preferred formulary option for acquired hemophilia (see FormWeb)

Dabigatran (PRADAXA) Reversal

• Idarucizumab (PRAXBIND) is now included on the PowerPlan for dabigatran-associated major bleeding

What You Need to Know

• All orders must be placed through the “HOSP Emergent Reversal of Oral Anticoagulants” PowerPlan
• Pharmacists should verify:
  • Correct anticoagulant selection within the PowerPlan
  • Appropriate use criteria and contraindications
  • Infusion rate based on patient weight, not to exceed 8.4 mL/min

Updated FormWeb resources are available for reference. Please reach out to the Anticoagulation Stewardship Team (7-4666) or the ED pharmacist on duty with any questions during go-live.

Thank you for your continued support in ensuring safe and timely anticoagulant reversal.

Sincerely,

256. Monroe Crawley, Pharm.D., BCPS, BCCCP, CACP
     Clinical Pharmacy Specialist, Anticoagulation Stewardship/Cardiac ICU
     Huntsville Hospital | Department of Pharmacy
     P: 256.265.9509 | C: 731.549.0531
     monroe.crawley@hhsys.org