Anticoagulation Reversal Dose
Anticoagulation Reversal Dose - a deterministic tool in Sophie Well's Medication & Infusion group.
Open the Anticoagulation Reversal Dose → Runs in your browser. No signup, no tracking.
What this is
Pull up the standard reversal options for the common anticoagulants on a single page - warfarin (vitamin K, four-factor PCC, fresh frozen plasma), dabigatran (idarucizumab), the direct factor-Xa inhibitors rivaroxaban / apixaban / edoxaban (andexanet alfa, four-factor PCC as an alternative), and the parenteral agents heparin (protamine) and enoxaparin (partial protamine reversal). Sophie Well lists the agent, the indication threshold, the typical dose, and the practical caveats (timing of the last anticoagulant dose, fibrinogen and platelet support, the cost and availability of the brand-name reversal agents).
When to use it
Use this when a patient on an anticoagulant presents with active major bleeding or needs an emergent procedure, when a covering provider is reviewing whether a recent intracranial hemorrhage warrants reversal versus expectant management, or when reviewing pharmacy stock before a high-risk procedure. The numbers here are reference values; the actual decision to reverse, which agent to use, and the supportive transfusion plan require attending and pharmacy input - the institutional protocol and current literature always supersede this table.
References
Frontera JA, et al. Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage (Neurocritical Care Society / SCCM). Neurocrit Care. 2016;24(1):6-46. Agent labels: 4F-PCC (Kcentra) INR-band dosing, idarucizumab 5 g, andexanet alfa (ANNEXA-4), protamine 1 mg/100 units (max 50 mg). Read the source ↗
Worked example: Warfarin, 80 kg, INR 5: 4F-PCC 35 units/kg = 2800 units + Vitamin K 10 mg IV.
Sophie Well is a reference and educational tool. Not medical, legal, or financial advice. Does not replace clinician judgment, professional billing review, or legal counsel.