Monograph

5. Fast Facts about Praxbind

During a typical day in community pharmacy, it's not surprising to have a couple sales representatives from pharmaceutical industries come by and drop off some leaflets about their new, amazing, no side-effects guaranteed! product. This is how I first came to hear about PraxBind, however, when I saw this drug being used on my hospital rotations I decided to do some more digging. So here are 4 quick facts about Praxbind:

1. It's a reversal agent: Praxbind reverses the anticoagulant effects of dabigatran (Pradaxa) and can thus be used in emergencies such as life-threatening or uncontrolled bleeding. It also can be used prior to emergent or urgent surgery to reverse the anticoagulant effects of dabigatran so that surgeons can operate quickly and safely, rather than waiting 5 days for Pradaxa to be cleared from the patient's system.

2. It's a humanized monoclonal antibody: It specifically targets, binds and essentially neutralizes dabigatran. Its affinity for dabigatran is 350-fold more potent than dabigatran's affinity for thrombin, making it incredibly specific, thus providing a good safety profile.

3. It works incredibly fast: PraxBind binds and reverses the effects of dabigatran within minutes

4. It does not mean that Pradaxa (Dabigatran) is a superior choice in anticoagulation: Praxbind is an amazing reversal agent which may tempt you into thinking that it must be safer for patients to be on dabigatran because "Hey! There's a reversal agent!" However, PraxBind is limited to the setting of surgeries and emergencies and most likely needs to be provided by a trained health care professional. Furthermore, many trials have shown that dabigatran has a higher risk of intracranial hemorrhage compared to other agents (i.e. apixaban, rivaroxaban and warfarin). Lastly, it's also mostly renally cleared leading to a risk of accumulation in patients with renal insufficiency and is therefore contraindicated in patients with a CrCl < 30 mL/min