New Anticoagulants reversibility?

[Simoni]

Hi, I was wondering if anyone has any info about the reversibility of the newer types of anticoagulants if needed? for example in an accident situation where bleeding is quite bad due to an injury.

cheers in advance.

[MrFizz]

I am on Xarelto and cut myself with a blade and wouldnt stop bleeding for 4 days. I have just orderred this cogaluant from Amazon - hasn’t arrived yet.

Cogulant powder

[MrFizz in reply to MrFizz]

and this...

Coagulant powder

[Thomas45 in reply to MrFizz]

Why would you want to self-medicate? Seek help from the professionals.

[HiloHairy in reply to Thomas45]

Because you could bleed to death waiting for professional help.

[Rosemaryb1349 in reply to MrFizz]

I have used Woundseal to good effect when I cut my finger badly once. I now carry one tube in my handbag for emergency use and the rest is in my medicine box.

[Desanthony in reply to MrFizz]

I bought this on recommendation from someone on here - funnily enough have not had reason to use it - thankfully.

[philcollis]

have a look at noaceducation.com

[jwsonoma]

Hi Simoni, They been developing them. Will every little town's clinic have the antidote for any particular drug should you get in an accident is the question?

I copied this out of Google:

The FDA approved andexanet alfa (AndexXa) on May 3, 2018. It's the first and only antidote to reverse bleeding in people taking apixaban (Eliquis), rivaroxaban (Xarelto), or edoxaban (Savaysa). Another newer blood thinner — dabigatran (Pradaxa) — already has an approved antidote called idarucizumab (Praxbind).

I read the antidote for Pradaxa cost $3,500 a dose. It may have changed.

My Dr. recommended I stay on Wafarin because I can have better control over coagulation with home testing. I keep my INR in the low 2s. I don't seem to bruise that much or bleed that excessively while still being protected. Vitamin K is ubiquitous.

[Cat04]

pubmed.ncbi.nlm.nih.gov/305...

[Peony4575]

I have read that in a severe situation , example car accident with severe injuries the best hope is a blood transfusion to try and replace the anti coagulated blood . I would imagine only major trauma centres might have the antidote to hand it is very expensive to just have on the shelf where it exists .

[Ducky2003 in reply to Peony4575]

I have read about a blood transfusion too.

[CDreamer]

Not something I worry about for reasons outlined by Peony ie: risk of encountering a severe internal bleed would be from trauma so you are unlikely to survive anyway.

In a less severe situation there are other procedures which can be performed & as the DOACs are FactorX inhibitors the great advantages of DOACs over Wafarin - which I refused to take - outweigh the negatives for me as the drug’s efficacy will decrease very quickly, unlike Wafarin which is VitK antagonist.

I’m on Apixaban - half life = 12 hours - & have been now for about 5 years. I’ve just broken my wrist & bruising was minimal. I’ve had a few falls, pacemaker implanted & revised, dental work and have only ever had to miss a maximum of 2 doses.

Just my view.

[Thomas45 in reply to CDreamer]

I tried what was then a NOAC, Rivaroxaban. I had severe pains throughout my body. I was taken off Rivaroxaban after 12 days and went back to Warfarin, and bought my own Coaguchek meter. I've once had a major cut on my lower leg. While a clean towel was pressed on the wound it was obvious that it was a hospital job.The paramedic who came first soon called for an ambulance and I first had the wound cleaned, and then closed with many closure strips. The wound was 5 inches x 2 inches near to my shin bone. It continued to bleed and I was admitted to hospital for two nights.

The wound was dressed by nurses at the local medical centre regularly, starting with three times a week. After three months I stopped seeing them. The long time for healing was because of the need to keep me anticoagulated.

Of course there are occasions when you need to be re-coagulated, for example for a hospital operation or procedure. It took my local hospital 12 hours to re-coagulate me prior to having my appendix out, the operation being at 2.30 on a Sunday morning.

[CDreamer in reply to Thomas45]

Everyone is individual and reacts differently. As a matter of interest - were you told to take Rivaroxaban with substantial meal and did you?

Having just read the slides from the Surrey AF Association which confirms that DOACs are preferable to Warfarin - for most people.

[Thomas45 in reply to CDreamer]

I can't remember. I suspect not as at that time I didn't eat at regular times and even now that I do I don't eat substantial meals.

[CDreamer in reply to Thomas45]

That’s always been the difficulty with Rivaroxaban, it requires to be taken food to be metabolised efficiently. Apixaban & Edoxaban don’t but Pradaxa & Rivaroxaban need to be taken with food to avoid stomach issues and be metabolised.

[Thomas45 in reply to CDreamer]

I suspect in my case it was Rivaroxaban which was the straw that broke the camel's back. The pains didn't go away when I stopped Rivaroxaban. After five weeks of pain and numerous tests one of my GPs phoned and asked me to go for another blood test, this one to test ESR, erythrocyte sedimentation rate, which indicates how much inflammation there is in your body. For men it should be around 20. Mine was at 130. I was deemed to have polymyalgia rheumatics , (PMR). After taking a very slowly reducing dose of prednisolone during just under four years I was deemed to be free of inflammation and PMR.

[Hidden]

As you can see, more information is becoming available about the availability of reversal agents for DOAC’s. However, the general thinking seems to be that anyone needing them because of a serious life threatening accident like the type you describe is unlikely to benefit unless it happened in close proximity to somewhere one of these agents would be available.

As with most things medical, treatments are subject to a balance of risks. I am 74 and I can only recall knowing one person who has died as a result of a road traffic accident where as I have come into contact with hundreds of folk who have been affected by having a stroke. I’m not suggesting that this is in any way a definitive means of assessing a risk but it may help in trying to keep things in perspective....

[MarkS]

Reversal agents for warfarin are readily available in all hospitals and even the air ambulance. The standard is PCC which reverses warfarin within 10 minutes. This is followed by Vit K which is longer acting.

[Simoni]

Thanks for the replies, much appreciated