Idarucizumab Dosing in Kidney Failure

In the case report by Novak et al,1 their use of a single idarucizumab dose and blood product therapy merits further discussion. We believe that idarucizumab dosing should be based on serial clinical assessments (eg, vital signs, hemorrhage site, and patient's response to therapy) and a profile of clotting times at least every 6 to 8 hours (eg, ecarin clotting time, thrombin clotting time, activated clotting time, and activated partial thromboplastin time) in addition to blood component therapy, as in Novak et al's clinical scenario.

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