NOAC associated bleeding

Posted On February 25, 2020

Time Anticoagulation effect resolved

5 half live since last dose
  • Dabigatran (Pradaxa): 2.5 to 3.5 days
  • Rivaroxaban (Xarelto): 1-2 days
  • Apixaban (Eliquis): 1.5 to 3 days

Management

  • Discontinue medication
  • Specific reversal agent
    • Dabigatran: idarucizumab (Praxbind)
      • initial dose 2.5 g iv, repeat in 20 min, total of 5 g
    • Apixaban, Rivaroxaban:
      • Andexanet alfa (AndexXa): initial dose depends of noac dose and interval since last dose
      • or 4 factor PCC (KCentra) 50 units/kg
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