II. Mechanism
- Anticoagulation Reversal agent
- Monoclonal Antibody specifically binds Dabigatran
III. Pharmacokinetics
- Half-Life: 1 hour
- Renally excreted
IV. Efficacy
- Idarucizumab is highly effective (100%) in initial studies and FDA approval
- Complete Dabigatran reversal within minutes with effect lasting >24 hours, without Hypercoagulable adverse effects
V. Dosing
- Idarucizumab 5 gram IV
VI. Disadvantages
- Expensive ($3500 wholesale in 2016)
VII. Adverse Effects
- Thrombosis risk 6% at 30 days
- Mild adverse effects (Headache, skin and infusion site irritation)
VIII. References
- Gartland and Abboud (2020) Crit Dec Emerg Med 34(1):18
- Buchheit (2016) Crit Pathw Cardiol 15(3):77-81 [PubMed]
- Pollack (2015) N Engl J Med 373(6): 511-20 +PMID: 26095746 [PubMed]
- Pollack (2017) N Engl J Med 377(5): 431-41 +PMID:28693366 [PubMed]