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Dabigatran overdose: case report of laboratory coagulation parameters and hemodialysis of an 85-year-old man
Dabigatran is an oral direct inhibitor indicated for stroke prevention in patients with atrial fibrillation. Unlike warfarin, dabigatran's observed therapeutic window and minimal drug-to-drug interaction suggest that laboratory test and dose adjustments are not necessary; nevertheless, circumstances of excessive anticoagulation, decreased kidney function, and instances of significant bleeding and thrombosis require laboratory assessment. In order to gather experience in the management of global [activated partial thromboplastin time (APTT) and thrombin time (TT) with extended endpoint] and specific [ecarin chromogenic assa...
Source: Blood Coagulation and Fibrinolysis - January 30, 2015 Category: Hematology Tags: Case Reports Source Type: research

Management of dabigatran-induced bleeding with continuous venovenous hemodialysis.
Abstract Dabigatran, a direct thrombin inhibitor, is increasingly used for stroke prevention in patients with non-valvular atrial fibrillation. Dabigatran has a stable pharmacokinetic profile with minimum drug interactions, and requires no routine laboratory evaluation to measure level of anticoagulation. This provides a huge advantage over warfarin, and has the potential to improve patient compliance. The disadvantages of dabigatran are the lack of a reversal agent to counter dabigatran-related bleeding and the absence of a widely available laboratory test that can quantify the extent of coagulopathy in dabigatr...
Source: International Journal of Hematology - January 30, 2015 Category: Hematology Authors: Paul S, Hamouda D, Prashar R, Mbaso C, Khan A, Ali A, Shah S, Assaly R Tags: Int J Hematol Source Type: research

Dabigatran overdose: a case report of acute hepatitis. Extracorporeal treatment.
We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration. Although extracorporeal therapy has been suggested as a strategy for clearing dabigatran during acute bleeding, this approach may be useful in other dabigatran-related, life-threatening conditions, such as that described in this report. PMID: 27910004 [PubMed - as supplied by publisher]
Source: International Journal of Hematology - November 30, 2016 Category: Hematology Authors: Porru M, Mameli A, Cianchetti ME, Musu M, Schirru P, Ruberto MF, Barcellona D, Marongiu F Tags: Int J Hematol Source Type: research

Intravenous Fat Emulsion Does Not Significantly Alter Clotting Markers in Dabigatran-Treated Blood
AbstractDabigatran etexilate is an oral direct thrombin (Factor IIa) inhibitor approved for patients with atrial fibrillation and for management of risk of deep vein thrombosis and pulmonary embolism. Dabigatran offers advantages over treatment with warfarin, including limited laboratory monitoring. It is equivalent in prevention of stroke and deep vein thrombosis with essentially equivalent complication rates. In contrast to warfarin, reversal of the anticoagulation is less well established. Idarucizumab is available for reversal, however supporting research is mixed; the agent also happens to be quite expensive making av...
Source: Indian Journal of Hematology and Blood Transfusion - June 21, 2020 Category: Hematology Source Type: research