Hematology and Oncology Book

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Idarucizumab

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

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