The Medical Letter on Drugs and Therapeutics
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Idarucizumab (Praxbind) - An Antidote for Dabigatran

The FDA has approved idarucizumab (Praxbind – Boehringer Ingelheim) for urgent reversal of the anticoagulant effect of the direct thrombin inhibitor dabigatran etexilate (Pradaxa).1 Idarucizumab is the first specific reversal agent to become available for one of the new oral anticoagulants.2

RISK OF BLEEDING WITH DABIGATRAN — As with all anticoagulants, severe, potentially fatal bleeding can occur with dabigatran. Unlike warfarin, routine laboratory monitoring to determine the extent of anticoagulation is not required with dabigatran and no specific agent has been available to reverse its anticoagulant effect in the event of life-threatening bleeding or emergency surgery. Dabigatran is dialyzable, but dialysis may not be feasible in patients with acute bleeding.3

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