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Pharmacologic Reversal of Direct Oral Anticoagulants

Farina, Nicholas, PharmD, BCCCP; Miller, James, T., PharmD, BCCCP

doi: 10.1097/CNQ.0000000000000193
Original Articles

Direct oral anticoagulants are becoming increasingly popular in outpatient use. These medications have lacked specific reversal agents. However, this is changing. The Federal Food and Drug Administration approved idarucizumab for reversal of dabigatran in 2016, and another agent, andexanet alfa, is currently in clinical trials for reversal of rivaroxaban and apixaban. This article examines the efficacy and safety of these emerging reversal agents, as well as other historical agents for reversal of direct oral anticoagulants.

Michigan Medicine Department of Pharmacy, Ann Arbor.

Correspondence: Nicholas Farina, PharmD, BCCCP, Trauma/Burn Critical Care, 1111 E. Catherine St Victor Vaughan Bldg Room 301, Ann Arbor, MI 48103 (

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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