Idarucizumab is a specific reversal agent for the novel oral anticoagulant (NOAC) dabigatran. Idarucizumab is indicated when rapid, complete and sustained reversal of dabigatran’s anticoagulant effect is needed, such as when the patient requires emergency surgery or an urgent procedure, or has life-threatening or uncontrolled bleeding.
Novel oral anticoagulants (NOACs) currently available in Australia include the thrombin inhibitor dabigatran and the factor Xa inhibitors apixaban and rivaroxaban. These agents (also known as non-vitamin K antagonist oral anticoagulants) are approved for use in patients with nonvalvular atrial fibrillation (AF), and for the prevention and treatment of venous thromboembolism. Their advantages over warfarin include minimal drug or food interactions, and no requirement for regular laboratory monitoring, although the dose must be carefully considered in elderly people and those with renal impairment.1
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