Praxbind (idarucizumab)

Praxbind (idarucizumab) is now on formulary and in stock at EHC.

Mechanism of action: Praxbind (idarucizumab) is an antibody fragment (Fab) that binds to Pradaxa (dabigatran) and its metabolites with higher affinity than the binding of Pradaxa (dabigatran) to thrombin. It is a specific reversal agent to Pradaxa (dabigatran) and neutralizes its anticoagulant effect. There is NO impact on the effect of other anticoagulant or antithrombotic therapies.

Indications: Life-threatening/uncontrolled bleeding or need for emergency surgery/urgent procedures in patients treated with Pradaxa (dabigatran).

Contraindications: None.

Recommended dose: 5 g, provided as two separate vials each containing 2.5 g/50 mL. A second 5 g dose may be required in patients with clinically relevant bleeding and elevated coagulation parameters or in patients who require a second emergency surgery/urgent procedure and have elevated coagulation parameters.

Administration: Two consecutive infusions by hanging vials or bolus injection by injecting both vials consecutively via syringe. Pre-existing itravenous line may be used. Flush intravenous line 0.9% NaCl solution prior to infusion/bolus injection. No other infusion should be administered in parallel via the same intravenous access.

Consultation: Neurosurgery and/or Surgery  and/or GI as appropriate. Consider Toxicology (NYCPCC) for continued guidance.