Table 7.

Recommended approach to the management of bleeding.

Type of bleed	Direct thrombin inhibitors (dabigatran)	FXa inhibitors (apixaban, rivaroxaban)
Nonlife-threatening	Estimate normalization of hemostasis (12–≥48 h depending on renal function)	Normalization of hemostasis 12–24 h
	General supportive measures	General supportive measures
	Consider tranexamic acid, desmopression, and/or dialysis	Consider tranexamic acid and/or desmopressin
	Charcoal hemoperfusion not recommended
Life-threatening	All of the above	All of the above
	Idarucizumab (where available)	PCC 25 U/kg
	Activated factor VII (rFVIIa; 90 μg/kg)	Activated PCC 50 IE/kg (max 200 IE/kg/d) if available
		Activated factor VII (rFVIIa; 90 μg/kg)

Note. From “Updated European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation: executive summary,” by H. Heidbuchel, P. Verhamme, M. Alings, M. Antz, H.C. Diener, W. Hacke, et al, 2015, Europace, 17, p. 1467–507. Copyright 20XX, Name of the Copyright Holder. Adapted with permission.

PCC = prothrombin complex concentrate.