My patient is taking dabigatran and has a major bleed. What should I do?

By William Aird

  • Consider idarucizumab.
  • Consider oral activated charcoal to prevent further absorption of dabigatran if last dose was taken in the last 2 hours.
  • If idarucizumab is not available, consider:
    • 4-factor PCC or activated PCC (aPCC).
    • Hemodialysis, hemofiltration, or charcoal hemoperfusion to facilitate further clearance of dabigatran, particularly in patients with renal failure.