Quick neutralisation of Dabigatran

The anticoagulation effects of Warfarin can be quite quickly neutralised with injections of Vitamin K in say the case of bleeding from an injury or the need for urgent surgery. This was not the case for Dabigatran or other, new, anticoagulants. How do Dabigatran patients feel about this risk and does anyone know of a new way of neutralising the new anticoagulants?

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  • Not an answer to this question but what happens with the new anticoagulants when you need planned surgery? Do they just stop it for a few days or give you heparin injections?

  • Yes they stop it a few days before surgery and give you a form of Heparin usually called Dalteparin which you can self inject until 12 hours before surgery and then you inject again starting 6-8 hours after surgery until the oral anticoagulant has become therapeutic again. Different hospitals do have varying "Bridging Protocols" as they call them but most are as I have described.

  • Tooth implant is considered planned surgery. I had to drop warfarin 4 days before the implant and take up my daily 5mg of warfarin immediatly afterwards.

  • the time an oral anticoagulant takes to clear from your body is called "the half life". With Dabigatran that is approximately 12 hours. However the drug has maximum concentration at approximately 2 to 3 hours and then this reduces.

    Warfarin half life is approximately 37 hours.

    If you required emergency treatment or surgery doctors have said that you would receive it and they would deal with any bleeding, the same for whether you were on warfarin on one of the newer oral anticoagulants.

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