Idarucizumab (Praxbind), the first reversal agent for one of the non-vitamin K oral anticoagulants, acts quickly and safely, according to a new study. More than 500 patients who were anticoagulated with dabigatran required reversal because of uncontrolled bleeding or need for an urgent procedure. Patients received 5 g of IV idarucizumab as two infusions 15 minutes apart. The maximum percentage reversal of dabigatran was 100%. In bleeding patients, the median time to cessation of bleeding was 2.5 hours. In the procedure group, 93.4% of patients exhibited normal periprocedural hemostasis at 1.6 hours. Within three months, thrombotic events occurred in 6.3% of the bleeding group and 7.4% of the procedure group. Mortality was about 19% in both groups. The authors concluded that “idarucizumab rapidly, durably, and safely reversed the anticoagulant effect of dabigatran.” (N Engl J Med 2017;377:431-441)