idarucizumab at a glance
Medicine class
Specific anticoagulant reversal agent
Target
Dabigatran and its active metabolites; it does not reverse other anticoagulants
Administration
Given intravenously by healthcare professionals in hospital
Licensed population
Adults requiring rapid dabigatran reversal
What is idarucizumab used for?
Licensed uses in adults taking dabigatran are:
Rapid reversal before emergency surgery or another urgent procedure.
Rapid reversal during life-threatening or uncontrolled bleeding.
How does idarucizumab work?
Idarucizumab binds dabigatran and its active metabolites with very high affinity, forming a stable complex that prevents dabigatran from inhibiting thrombin. This removes dabigatran’s anticoagulant activity without directly reversing other anticoagulants.
idarucizumab preparations and strengths
Injection
Route: Parenteral
Strengths: 2.5 g/50 mL
How to take idarucizumab
Idarucizumab is not taken at home. A healthcare professional gives the ready-to-use solution into a vein by infusion or injection. It must not be mixed with other medicines; if an existing intravenous line is used, the line is flushed and no other infusion is run through that access at the same time.
The solution is checked for particles or discolouration before use.
Each vial is for single use and contains no preservative.
Food and drink do not affect administration.
idarucizumab side effects
Get urgent medical advice
- Serious hypersensitivity or anaphylactic reactions may cause breathing difficulty, swelling, rash, faintness or collapse.
- Blood clots may occur after dabigatran is reversed because protection from the person’s underlying thrombotic condition has been removed.
idarucizumab in pregnancy
There are no adequate data from pregnant women and reproductive toxicity studies have not been performed. In an emergency, idarucizumab may be used when the expected clinical benefit outweighs potential risks, following specialist assessment.
idarucizumab while breastfeeding
It is not known whether idarucizumab or its metabolites pass into human milk. The clinical team should assess breastfeeding in the context of the emergency and the parent’s ongoing treatment.
idarucizumab interactions
Formal interaction studies have not been performed. Clinically important interactions are considered unlikely because idarucizumab binds very specifically to dabigatran.
Dabigatran
Idarucizumab binds and neutralises dabigatran’s anticoagulant effect; this is its intended action.
Other anticoagulants
Idarucizumab does not reverse factor Xa inhibitors, heparins, vitamin K antagonists or thrombin inhibitors other than dabigatran.
Other intravenous medicines
They must not be mixed with idarucizumab or infused simultaneously through the same intravenous access.
Common questions about idarucizumab
Answers are fully visible for fast scanning and source review.
What is idarucizumab used for?
It rapidly reverses dabigatran anticoagulation in adults with life-threatening or uncontrolled bleeding or who need emergency surgery or an urgent procedure.
Does it reverse other anticoagulants?
No. It specifically targets dabigatran and does not reverse factor Xa inhibitors, warfarin, heparins or other anticoagulants.
How quickly does it work?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.