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2019 | 2 | 1 | 44-47
Article title

Postponed absorption of dabigatran in a patient with paralytic ileus – difficulties in decision making on reversal agent (idarucizumab) use

Content
Title variants
Languages of publication
EN
Abstracts
EN
According to the European Society of Cardiology (ESC) guidelines, non-vitamin K antagonist oral anticoagulants (NOACs) are first choice drugs in prevention of thromboembolic events among patients with atrial fibrillation (AF). According to our knowledge this was the only case of delayed absorption of dabigatran due to ileus. A 79-year-old woman with hypertension and a 1-year history of persistent AF treated with dabigatran (a direct thrombin inhibitor approved for the prevention of stroke in patients with non-valvular AF) 110 mg bid for two weeks. She was hospitalized due to acute abdominal pain, vomiting and diarrhea. Signs of acute embolism of abdominal aorta (paraparesis) were confirmed on contrast-enhanced computed tomography scan and she was qualified for emergency surgery. The use of idarucizumab, the specific reversal agent for dabigatran, was considered twice. This case shows that exposure to dabigatran may occur later in patient with acute ileus due to alterations in absorption than it can be expected in normal situation. Such patients should be carefully monitored for a significant rebound in anticoagulant activity.
Year
Volume
2
Issue
1
Pages
44-47
Physical description
Dates
published
2019-06-04
received
2018-12-16
accepted
2019-05-12
References
  • Pollack Jr C V, Reilly PA, Eikelboom J, Glund S, Verhamme P, Bernstein RA, et al. Idarucizumab for dabigatran reversal. N Engl J Med. 2015;373(6):511–20.
  • Pruszczyk P, Tomaszuk-Kazberuk A, Słowik A, Drwiła R, Rydzewska G, Filipiak KJ, et al. Management of bleeding or urgent interventions in patients treated with direct oral anticoagulants: 2017 recommendations for Poland. Pol Arch Intern Med. 2017;127(5):343–51.
  • Tomaszuk-Kazberuk A, Łopatowska P, Młodawska E, van Ryn J, Reilly PA, Pollack C V. Successful use of idarucizumab as a reversal agent for dabigatran in a patient with acute dissected aortic aneurysm. Pol Arch Intern Med. 2017;127(1):68–70.
  • Eikelboom JW, Quinlan DJ, van Ryn J, Weitz JI. Idarucizumab: the antidote for reversal of dabigatran. Circulation. 2015;132(25):2412–22.
  • Lang T, Bauters A, Braun SL, Pötzsch B, von Pape K-W, Kolde H-J, et al. Multi-centre investigation on reference ranges for ROTEM thromboelastometry. Blood Coagul fibrinolysis. 2005;16(4):301–10.
  • Reilly PA, Lehr T, Haertter S, Connolly SJ, Yusuf S, Eikelboom JW, et al. The effect of dabigatran plasma concentrations and patient characteristics on the frequency of ischemic stroke and major bleeding in atrial fibrillation patients: the RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulation Therapy). J Am Coll Cardiol. 2014;63(4):321–8.
  • Hankey GJ, Eikelboom JW. Dabigatran etexilate: a new oral thrombin inhibitor. Circulation. 2011;123(13):1436–50.
  • Thorborg C, Horn E-P, Mofid H, Langer F. Reversal by the specific antidote, idarucizumab, of elevated dabigatran exposure in a patient with rectal perforation and paralytic ileus. Br J Anaesth. 2016;117(3):407–9.
  • The summary of product characteristics (SmPCs): Pradaxa 150 mg.
Document Type
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.doi-10_31373_ejtcm_109298
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