We received a call from one of our cardiologist informing us that he was going to start using Pradaxa rather than coumadin for his patients, and we needed to develop a "reversal strategy". Best I can tell, there is no reversal for this drug, but it does have a nice, short half-life.

Does anyone have a specific policy for dealing with patients on this medication who are having emergent surgeries?

Excuse me,......I thought it was the physician's job to treat the patient. (Silly me!)

But, we'll still be the ones dealing with the mess when he doesn't have a plan.

Did you already check out the links on the other pradaxa string on here? Just search pradaxa.

We do not have a specific strategy at this time. I found this link a couple of days ago:

https://www.rely-trial.com/RelyWeb/resources/jsp/emergency/dabigatran_bg.jsp

Since the orders for reversal would need to be written by an MD I believe, like L106, that this falls to the physician. Time to get your medical director involved.

Yup, time to visit the medical director.

Just to ask - my mom was just recently placed on this drug because she never tolerated coumidin well. Does anyone have a reversal scheme? Any ideas? Any guesses?

We are going to get together with our pathologists and cardiologists and see what we can come up with - see, in fact, if there is a problem or if this drug will not be as much of a problem as coumidin was to begin with.....

According to the package insert there is no known mechanism to reverse dabigatram; it states to treat an overdose symptomatically. If ECT or aPTT are elevated, use FFP; if low platelet count, give platelets.