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Karli B, Bartel B, Pavelko R. Reversal Strategies for Intracranial Hemorrhages in Patients Taking Oral Factor Xa Inhibitors. Hosp Pharm. 2015;50(7):569-77doi: 10.1310/hpj5007-569.
Karli, B., Bartel, B., & Pavelko, R. (2015). Reversal Strategies for Intracranial Hemorrhages in Patients Taking Oral Factor Xa Inhibitors. Hospital pharmacy, 50(7), 569-77. https://doi.org/10.1310/hpj5007-569
Karli, Betsy, et al. "Reversal Strategies for Intracranial Hemorrhages in Patients Taking Oral Factor Xa Inhibitors." Hospital pharmacy vol. 50,7 (2015): 569-77. doi: https://doi.org/10.1310/hpj5007-569
Karli B, Bartel B, Pavelko R. Reversal Strategies for Intracranial Hemorrhages in Patients Taking Oral Factor Xa Inhibitors. Hosp Pharm. 2015 Jul;50(7):569-77. doi: 10.1310/hpj5007-569. Epub 2015 Jul 31. PMID: 26448667; PMCID: PMC4589860.
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Hosp Pharm. 2015 Jul;50(7):569-77. doi: 10.1310/hpj5007-569. Epub 2015 Jul 31.

Reversal Strategies for Intracranial Hemorrhages in Patients Taking Oral Factor Xa Inhibitors.

Hospital pharmacy

Betsy Karli, Billie Bartel, Rachel Pavelko

Affiliations

  1. PGY2 Critical Care Pharmacy Resident, Avera McKennan Hospital and University Health Center , Sioux Falls, South Dakota.
  2. Critical Care Clinical Specialist, PGY2 Critical Care Pharmacy Residency Program Director, Assistant Professor, Department of Pharmacy Practice, South Dakota State University College of Pharmacy , Brookings, South Dakota.
  3. PGY1 Pharmacy Resident, Avera McKennan Hospital and University Health Center , Sioux Falls, South Dakota.

PMID: 26448667 PMCID: PMC4589860 DOI: 10.1310/hpj5007-569

Abstract

Factor Xa (fXa) inhibitors are becoming more common in clinical practice due to a variety of reasons. Unfortunately, limited data are currently available on the safe and efficacious reversal of these agents. This series presents 3 patient cases of intracranial hemorrhage and illustrates the observed effect of different methodologies undertaken in an attempt to reverse the fXa inhibitors implicated. Additionally, a brief review of the current available literature in reversal strategies is provided. The appropriate reversal for fXa inhibitors at this time is unknown. The cases described indicate that the administration of fresh frozen plasma and 4-factor prothrombin complex concentrate may provide minimal benefit in reversing the coagulation abnormalities caused by fXa inhibitors. However, in a life-threatening situation, the addition of these agents should be considered to prevent further progression of the bleed.

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