Saturday, March 9, 2019

bleeding with direct oral anticoagulants (DOACs)

Q: If bleeding occurs with direct oral anticoagulants (DOACs), oral activated charcoal can be administrated if the last dose is within last two hours? (select one)

A) Yes
B) No

Answer: A

In case of bleeding with DOACs,, there is a Grade 2C recommendation to administer oral activated charcoal if the last anticoagulant dose is within the previous two hours for dabigatran and edoxaban, six hours for apixaban, and eight hours for rivaroxaban.




1. Siegal DM, Garcia DA, Crowther MA. How I treat target-specific oral anticoagulant-associated bleeding. Blood 2014; 123:1152. 

2. Tomaselli GF, Mahaffey KW, Cuker A, et al. 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2017; 70:3042. 

3. Kaatz S, Kouides PA, Garcia DA, et al. Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors. Am J Hematol 2012; 87 Suppl 1:S141.

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