Idarucizumab is indicated for patients treated with dabigatran (Pradaxa) when reversal of the anticoagulant effects of dabigatran is needed.

*** Idarucizumab will not reverse the effects of other anticoagulants***

***Idarucizumab can be given to patients who have received other supportive measures

(fresh frozen plasma, prothrombin complex concentrates, Factor VII)***

Inclusion Criteria:  (must meet all) 

1. Patient has overt, uncontrollable, life-threatening bleeding or patient requires emergent surgery/procedure and current bleeding level could become life-threatening during surgery/procedure.
2. Confirmed or highly suspected dabigatran use within the last 48hrs if creatinine clearance > 50 mL/min or within the last 5 days if creatinine clearance < 50 mL/min.

Exclusion Criteria:  (any one of the following)

1. Absence of clinical signs of active major bleeding or hemodynamic instability
2. Minor bleeding that can be managed with supportive care. (half-life of dabigatran is ≈ 12-17 hrs)
3. Elective surgery/invasive procedure
4. Surgery/invasive procedure in which the risk of uncontrolled or unmanageable bleeding is low.
5. Hereditary Fructose Intolerance (Idarucizumab contains 4 g sorbitol)

Reviewed: 17 Nov 2015 (Praxbind)

Updated: April 2022 (Praxbind)

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