Idarucizumab Dabigatran Reversal — ORE Part 1 MCQ

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ModeratePharmacology & TherapeuticsIdarucizumab Dabigatran ReversalORE Part 1

A patient taking dabigatran has persistent post-extraction bleeding despite appropriate local haemostatic measures and requires urgent hospital management. Which medicine is the specific reversal agent for dabigatran?

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Reveal the answer and explanation

Correct answer: B — Idarucizumab

The answer is **A. Idarucizumab**. It is the specific antidote to dabigatran and is licensed for adults when rapid reversal is required for life-threatening or uncontrolled bleeding, or before emergency surgery or an urgent procedure. It binds dabigatran directly and neutralises its anticoagulant effect. In dental practice, persistent bleeding despite local measures requires urgent assessment; reversal is a hospital-led decision rather than routine primary-care treatment. Andexanet alfa reverses factor Xa inhibitors, not dabigatran. Vitamin K reverses warfarin anticoagulation. Protamine sulphate reverses heparin, particularly unfractionated heparin. Tranexamic acid is an antifibrinolytic adjunct and does not specifically reverse dabigatran.

Reference: Electronic Medicines Compendium. Praxbind 2.5 g/50 mL solution for injection/infusion: Summary of Product Characteristics, sections 4.1, 4.2 and 5.1, 2024. https://www.medicines.org.uk/emc/product/5073/smpc