The FDA approved idarucizumab in October as the first reversal agent for dabigatran. As far as we know it has not yet been approved for use in CanadaĬlinical Question: Is idarucizumab safe and effective treatment adjunct for patients taking dabigatran with serious bleeding or who require an urgent procedure? Boehringer Ingleheim the maker of dabigatran has developed a monoclonal antibody fragmin called idarucizumab. There has been no feasible reversal agent until now. The only current method of removal, hemodialysis, is impractical in the vast majority of clinical situations. Unlike warfarin that can be reversed in a variety of ways, there has been no feasible or effective method for the adjunctive treatment of these life-threatening bleeds in patients using dabigatran. Life threatening bleeding can occur while taking dabigatran. It is also approved treatment of non-valvular atrial fibrillation to prevent stroke. It is approved for the prevention and treatment of venous thromboembolism. He arrives via ambulance with a blood pressure of 120/70, heart rate of 74 beats per minute and O 2 saturation of 98% on room air.īackground: Dabigatran is a non-vitamin K antagonist anticoagulant that works by inhibiting thrombin. He had been having mild epigastric pain for about one week and had one episode of coffee ground emesis that night.

He takes metoprolol 50mg twice daily and dabigatran 150mg twice daily. He has a blog called Emergency Medicine Literature of Note.Ĭase : A 67-year-old man presents with a history of atrial fibrillation and hypertension. Ryan Radecki is Clinical Practice Lead at Kaiser Permanente North West and Clinical Assistant Professor of Emergency Medicine – The University of Texas Medical School at Houston.

Cost of idarucizumab