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Anticipating the Need for DOAC Reversal: Understanding Risks and Planning Reversal Strategies


This accredited activity has been designed for pharmacists.


Because DOAC use is increasing, bleeding events related to these agents are likely to increase even though they have a lower bleeding risk. New reversal agents are becoming available for patients who require rapid reversal of anticoagulation in the event of unplanned surgery or major bleeding, such as ICH. Pharmacists need education on the burden of ICH, reversal agents, and guidelines/recommendations so that they may participate in formulary decisions and protocol development for DOAC reversal. The ability to rapidly address bleeding issues can lead to improved patient outcomes. Having pharmacist experts available can facilitate these improvements.


Upon completion of this educational activity, participants should be better able to:

- Review the burden of intracranial hemorrhage (ICH) on patients and healthcare resources, including the impact of ICH in patients taking oral anticoagulants such as vitamin K antagonists or direct oral anticoagulants (DOACs)

- Examine agents used for reversal of anticoagulation in DOAC-associated bleeding events, including DOAC-specific agents available or in development

- Apply guideline recommendations for DOAC reversal or interruption to clinically relevant situations

- Develop strategies to improve protocols that include reversal of anticoagulation and formulary management related to DOAC-treated patients who require surgery or experience bleeding events

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