Reversal of dabigatran and apixaban-induced coagulopathy using idarucizumab, fibrinogen, and prothrombin complex concentrate: A case report

This case report examines the combined use of fibrinogen concentrate, four-factor prothrombin complex concentrate (PCC), and idarucizumab, a specific antidote for dabigatran, to reverse the anticoagulant effects of dabigatran and apixaban-induced coagulopathy. An 86-year-old patient, receiving apixaban therapy, presented to the Emergency Department after intentionally ingesting 50 tablets of dabigatran. The combination therapy contributed to the rapid normalization of coagulation parameters and stabilization of the patient's clinical status without subsequent thromboembolic complications. This case adds to the limited evidence on the effectiveness and safety of combining PCC with idarucizumab in cases of multiple anticoagulant intoxication.