Dabigatran is a direct oral anticoagulant (DOAC) that directly inhibits thrombin. Its specific reversal agent approved for life-threatening bleeding is:

• A Andexanet alfa
• B Protamine sulfate
• C Vitamin K (phytomenadione)
• D Idarucizumab ✓

Explanation

Idarucizumab (Praxbind) is a humanised monoclonal antibody fragment (Fab) that binds dabigatran with 350-fold higher affinity than thrombin, completely neutralising its anticoagulant effect within minutes. It is specific for dabigatran among the DOACs. Andexanet alfa (a modified factor Xa decoy) reverses factor Xa inhibitors (rivaroxaban, apixaban, edoxaban). Protamine reverses unfractionated heparin (and partially LMWH). Vitamin K reverses vitamin K antagonists (warfarin).

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.