Idarucizumab for reversal of dabigatran etexilate-induced gastrointestinal bleeding
10.3760/cma.j.cn114015-20240304-00129
- VernacularTitle:依达赛珠单抗逆转达比加群酯所致消化道出血
- Author:
Qi LIN
1
;
Shujie DONG
;
Lei LI
;
Kun WANG
;
Junbao SHI
;
Li YANG
Author Information
1. 北京大学第三医院药剂科，北京 100191
- Publication Type:Journal Article
- Keywords:
Dabigatran;
Gastrointestinal hemorrhage;
Idarucizumab
- From:
Adverse Drug Reactions Journal
2025;27(1):53-55
- CountryChina
- Language:Chinese
-
Abstract:
An 82-year-old female patient with atrial fibrillation and heart failure was treated with dabigatran etexilate 110 mg twice daily for 6 years. Two months ago, the patient′s lower limb edema was aggravated and urine output was reduced. Considering the worsening of the patient′s heart failure, torasemide tablets and spironolactone tablets were given, but her symptoms were not improved. Two days ago, the patient had scattered petechiae on the whole skin, tarry stools, and reduced urine (200 ml daily). Laboratory tests showed hemoglobin (Hb) 63 g/l, prothrombin time (PT) 39.5 s, activated partial thromboplastin time (APTT) 117.2 s, thrombin time (TT) >300 s, and international normalized ratio (INR) 3.64; the fibrinogen (Fib) could not be measured. Coagulation dysfunction and gastrointestinal bleeding caused by dabigatran etexilate were considered. Dabigatran etexilate was discontinued, and intravenous infusion of idarucizumab injection (2.5 g) was given twice. Then gastrointestinal bleeding in the patient disappeared and laboratory tests showed PT 12.7 s, APTT 42.4 s, TT 18.8 s, INR 1.18, and Fib 2.67 g/L. After 8 days, the patient′s cardiac function was improved, the skin ecchymosis subsided, and laboratory tests showed Hb 84 g/L, PT 14 s, APTT 37.8 s, TT 41.2 s, INR 1.3, Fib 2.26 g/L, and negative fecal occult blood test.
