I was reviewing patient comments for both types of drugs. Under Pradaxa, it was stated that a major bleed was not reversible with this drug but that it was reversible with rivaroxaban. Then under Rivaroxaban, it said the opposite - that a bleed was not reversible with rivaroxaban, but could be with Pradaxa. What is correct?
Unlike warfarin which has a simple shot as antidote, the new anticoagulants have no antidote, nor can they be removed with dialysis. Here is what the FDA says about rivaroxaban A specific antidote for rivaroxaban is not available. Because of high plasma protein binding, rivaroxaban is not expected to be dialyzable [see Clinical Pharmacology (12.3)]. Protamine sulfate and vitamin K are not expected to affect the anticoagulant activity of rivaroxaban. There is no experience with antifibrinolytic agents (tranexamic acid, aminocaproic acid) in individuals receiving rivaroxaban. There is neither scientific rationale for benefit nor experience with systemic hemostatics (desmopressin and aprotinin) in individuals receiving rivaroxaban. Use of procoagulant reversal agents such as prothrombin complex concentrate (PCC), activated prothrombin complex concentrate (APCC), or recombinant factor VIIa (rFVIIa) may be considered but has not been evaluated in clinical trials.
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