There are two primary classes of FDA-approved parenteral anticoagulants: Reversal of Parenteral and Subcutaneously Administered Anticoagulants In this chapter, the reversal of oral, parenteral and subcutaneous anticoagulants will be discussed with a focus on recommendations found in the Antithrombotic Therapy and Prevention of Thrombosis: American College of Chest Physicians Evidence-Based Clinical Practice (ACCP) Guidelines and the American Society of Hematology (ASH) guidelines for management of venous thromboembolism. Use of anticoagulation for stroke prevention in patients with atrial fibrillation and the treatment and prevention of venous thromboembolic events continues to rise. The direct oral anticoagulants, dabigatran, rivaroxaban, and apixaban all have specific reversal agents that can be used however, in centers where these medications are not available prothrombin complex concentrates could be considered particularly for the reversal of the factor-Xa inhibitors.Vitamin K antagonists can be reversed by Vitamin K, plasma, or prothrombin complex concentrate.Parenteral anticoagulants have a short half-life and in many scenarios stopping the medication infusion is all that is necessary for reversal.bleeding versus surgical procedure versus supratherapeutic drug levels).

Reversal of anticoagulation is dependent on the type of anticoagulant and indication for reversal (ie.

Anticoagulant antidote vitamin k