Table 2 Practical guide for how to manage bleeding complications in patients on direct oral anticoagulants
From: Management of bleeding in patients treated with direct oral anticoagulants
Oral thrombin inhibitors (dabigatran) | Oral factor Xa inhibitors (rivaroxaban, apixaban, edoxaban) |
|---|---|
None life-threatening bleeding | |
   Check last intake; restoration of normal coagulation to be expected at 12–24 h (in case of creatinin clearance > 80 ml/min) or 24–36 h (in case of creatinin clearance 50–80 ml/min) | |
   Local hemostatic interventions, fluid management, transfusion | |
   Consider tranexamic acid (1000 mg 3dd) or DDAVP (0.3 μg/kg) | |
Life-threatening bleeding | |
All of the above | All of the above |
Idarucizumab | Andexanet alfa |
| Â | Ciraparantag (under investigation) |
Prothrombin complex concentrate (no evidence) | Prothrombin complex concentrate (healthy volunteer data) |
Activated PCC (no evidence) | Activated PCC (no human evidence) |
Recombinant factor VIIa (no evidence) | Recombinant factor VIIa (healthy volunteer data) |