Bleeding following New Oral Anticoagulants (e.g. dabigatran)

The new oral anticoagulant currently in use in NZ is dabigatran (a direct factor lla, or thrombin, inhibitor). This agent reaches maximum effect 1.5 to 3 hours after an oral dose. Dabigatran half-life is 12-14 hours. The major adverse effect of all anticoagulant medications is bleeding. A specific antidote to reverse dabigatran is available from the CDHB Pharmacy Department (See Idarucizumab on Hospital HealthPathways - Bleeding After Dabigatran). The anticoagulant effect will not be reversed by administration of vitamin K or plasma infusion. There are two types of responses to bleeding events in this setting:

Standard response to bleeding:

New anticoagulant reversal, if standard response fails to control bleeding:

Crowther et al. Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agents. Blood 2008;111(10):4871-4879


About this Canterbury DHB document (34073):
Document Owner:	Not assigned (see Who's Who)
Last Reviewed:	August 2016
Next Review:	August 2018
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
Send Feedback Send Feedback	Expand All Drop-downs