Idarucizumab (PraxBind)
Liverpool Hospital Emergency Department
Indications:
- Monoclonal antibody fragment
- Rapid reversal of anticoagulant effects of dabigatran
- Emergency surgery/ urgent procedures
- Life-threatening or uncontrolled bleeding
- Remember haemostasis must be obtained too for bleeding
Please consult on call Haematologist advice and obtain from blood bank
Formulation:
- 50 mg/mL, 50 mL (2.5g) vial. (2 vials in each box)
Dosage and Administration
- Administered by 2 consecutive IV bolus injections of 2.5g, each over 5-10minutes.
- Seek specialist advice when a second 5g dose of Idarucizumab is considered.
- The above dosage was derived to manage bleeding in the setting of therapeutic drug use and may be insufficient in significant poisoning.
- Consent form is required as is a blood product
Monitoring before administration and 30 minutes after administration:
- aPTT
- PT
- Fibrinogen
- TT (thrombin clotting time)
Side Effects
- Infusion reactions include fever, bronchospasm, rash and itching
- Transient proteinuria
Pit Falls
- Only indicated if the TT is prolonged
- Resumption of anticoagulant therapy should be considered with specialist advice
- May be initiated 24 hours after administration of Idarucizumab