What is idarucizumab?

By William Aird

A humanized monoclonal antibody fragment targeted against the DOAC, dabigatran (idarucizumab binds to dabigatran with about 350 times greater affinity compared to thrombin). Indicated for the reversal of the anticoagulant effects of dabigatran in patients with life-threatening or uncontrolled bleeding or in patients having emergency surgery or urgent procedures.

More about idarucizumab:

  • Half-life is about 45 minutes in patients with normal renal function
  • Half-life is prolonged in patients with renal impairment
  • Both thrombin-bound and free dabigatran are bound by idarucizumab
  • Idarucizumab is given as a 5 g IV infusion (each dose given as 2 consecutive infusions of 2.5 g each)
  • Adverse effects include
    • Hypokalemia
    • Delirium
    • Constipation
    • Fever
    • Pneumonia