NOACs

Properties of Warfarin and NOACs available in the US Potential advantages and disadvantages of NOACs v.s. Warfarin

Antidote: 

• Dabigatran = Idarucizumab (Praxabind)  Idarucizumab for Dabigatran Reversal  N Engl J Med 2015; 373:511-520
• Factor Xa (Apixaban, Rivaroxaban) are POTENTIALLY reversible by Andexanet alfa (study was done in healthy human subjects, Andexanet reverses effect while infusion is running but rebounds on completion, further data will be available later)  ANNEXA-4 trial   N Engl J Med 2016;375:1131-41.
• Aripazine (PER977) is a medication currently on trial and can potentially reverse Factor Xa, dabigatran AND heparin, LMWH  Use of PER977 to Reverse the Anticoagulant Effect of Edoxaban  N Engl J Med 2014; 371:2141-2142