logoThe People's Perspective on Medicine

Is There an Antidote to Pradaxa?

Praxbind is now available as a way to reverse the anticoagulant action of dabigatran (Pradaxa) in a bleeding emergency.
Emergency Cardiology. ECG with supraventricular arrhythmias and short paroxysm of atrial fibrillation

The human heart pushes blood out through the body to all the organs by beating rhythmically. When that rhythm falters, as it does in the condition termed atrial fibrillation, blood is still pumped but less effectively.

Why Is A-Fib So Risky?

These rapid and weak contractions of the upper chambers of the heart can allow some of the blood that would normally have been pumped away to hang around in the heart, possibly long enough to form a clot. If such a clot is then pumped out into circulation, it can lodge in the brain, causing a stroke.

The exact size of the clot and the location where it lodges may determine how much damage is caused. The speed of receiving care, including anti-clotting medication, can also have an impact on stroke damage.

Preventing Blood Clots:

That is why most people with a-fib, or atrial fibrillation, are prescribed a medication to prevent clotting. The first and for many years the only one that was used was warfarin (Coumadin). Although warfarin is a very useful drug, it can be difficult to manage because it interacts with foods and other medicines that can alter its effectiveness. Usually people on warfarin need to have their INR (international normalized ratio, a measure of coagulation) measured on a regular basis, and the dose may need to be adjusted.

Newer Anticoagulants:

The appeal of the newer medications is that they don’t have dosage adjustments and there are no routine measurements of how well they are working. Dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis) are all prescribed for this purpose. Although they don’t interact with foods as warfarin does, they are all quite pricey and do not have easily made dose adjustments. Until quite recently, none could be reversed with another drug. That is in contrast to warfarin, which can be reversed with vitamin K in an emergency.

Reversing Pradaxa?

Q. My last visit to the cardiologist indicated that I have atrial fibrillation again in spite of the Multaq that I am taking. The doctor said to keep taking one aspirin at night, stop taking Multaq and take Pradaxa twice a day. According to him, it’s better than Coumadin.

He was adamant that Pradaxa has an antidote, though I’d always heard that there is not one. What is the story on this?

A. Until this fall, there was no antidote to dabigatran (Pradaxa). In October, the FDA approved Praxbind to reverse the anticoagulant effect of Pradaxa in emergencies.

The most serious side effect of Pradaxa is uncontrollable bleeding, so doctors will no doubt find it helpful to have a compound that can reverse the effects of Pradaxa within minutes (New England Journal of Medicine, Aug. 6, 2015).

Rate this article
4.6- 18 ratings
About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Tired of the ads on our website?

Now you can browse our website completely ad-free for just $5 / month. Stay up to date on breaking health news and support our work without the distraction of advertisements.

Browse our website ad-free
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 6 comments
Add your comment

I am taking Xarelto 20mg and was about to ask the question of reversing the effect of bleeding but it was answered…Please keep me updated on the trials, if possible.

Since there has been an antidote developed for Pradaxa, can you tell me if there is now one for Xarelto (which is what my husband is on)???

It is undergoing clinical trials at this time; it is not yet available.

Husband had AF and his Doctor has him taking NATTOKINASE which did the trick!!
Big Pharma had it taken off the market in Canada as it was cutting into their Drugs for this and they were able to lobby the Government. So we have to get it in USA…

Enzyme therapies (taking proteolytic enzymes between meals) are excellent at things like dissolving and preventing clots. They can do a lot of other “clean-up” work in the body, too, which can prevent big problems.
Enzymes are generally very safe, but there are a few contraindications. It’s very helpful to learn for yourself about nattokinase, serrapeptase, and other useful enzymes.

re. antidote to Pradaxa ~ is there one for Xarelto?
I started on Pradaxa and asked cardiologist to switch because ~
1. I hated the twice a day routine.
2. Had trouble getting capsule from packaging.
3. Capsule was so large that swallowing it was difficult.
Xarelto is once a day and much smaller and no blister packaging.
But, is there an antidote?

* Be nice, and don't over share. View comment policy^