Idarucizumab binds specifically to dabigatran and its metabolites and will not reverse the effects of any other anticoagulant. It is licensed for use in adults treated with dabigatran etexilate ( Pradaxa, Boehringer Ingelheim Limited) when rapid reversal of its anticoagulant effects is required for emergency surgery or urgent procedures, or in life‑threatening or uncontrolled bleeding. Regulatory status: Idarucizumab ( Praxbind, Boehringer Ingelheim Limited) was launched in the UK in December 2015. People may still need other supportive measures, for example blood products, to manage their bleeding and these should be considered as medically appropriate. In the interim analysis of an ongoing, phase III, uncontrolled, cohort study (RE‑VERSE AD n=90), treatment with a 5 g dose of idarucizumab completely reversed the anticoagulant effect of dabigatran etexilate in adults who had either serious bleeding or required urgent surgery. Its action is specific against the NOAC dabigatran etexilate. Idarucizumab is the first agent to be licensed in the UK that reverses the anticoagulant effect of a non‑vitamin K antagonist oral anticoagulant (NOAC).
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