In the event of acute ingestion of Pradaxa (< 2 hours), administering activated charcoal will help absorb Pradaxa. Administering fluids, blood, and monitoring the patient as dictated by the situation or hospital protocol for acute bleeds is recommended.
Hemodialysis can remove 60% of dabigatran. Dabigatran is eliminated through the kidneys. The half-life increases by 24 hours when dabigatran is given in patients with impaired renal function (creatinine clearance < 30 ml/min). Natural elimination is through the urine.
Antifibrinolytic agents may be considered for moderate to severe bleeding. Intravenous tranexamic acid along with fluid replacement and blood product transfusion may be used. Prothrombinex-VF can be used to restore normal clotting factor IX, factor II, factor X and low level of factor VII.
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