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Clinical reviews
ANTIDOTES FOR ANTICOAGULATION REVERSAL
Bianca Rocca, M.D., Ph.D., Hugo ten Cate, M.D., Ph.D.
PDF20 pages986 KB
The global rise in anticoagulant use has led to an increase in major bleeding events that require timely pharmacologic reversal. This article reviews the pharmacodynamics and pharmacokinetics of various anticoagulants and their antidotes, including protamine sulfate, four-factor prothrombin complex concentrates, idarucizumab, and andexanet alfa. It emphasizes the importance of patient-specific factors and the need for high-quality evidence to guide treatment decisions. Challenges such as dosing, laboratory monitoring, and the development of guidelines for perioperative treatment are also discussed.
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