Idarucizumab (PraxBind)

Liverpool Hospital Emergency Department


  • 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  


  • 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