Elective Reversal (reversal needed within days)

• Hold 24-48 hrs before procedure

Urgent Reversal (not bleeding, reversal needed within hours)

• Hold further doses
• Consider:
  1. Activated charcoal if ingestion <8 hrs
  2. 4-factor PCC (Kcentra 25 units/kg, max 2500 units)/ aPCC*
  3. 3-factor PCC + FFP

Urgent Reversal (bleeding, reversal needed immediately)

• HASHTI

1. Activated charcoal if ingestion <8 hrs
2. 4-factor PCC (Kcentra 50 units/kg, max 5000 units)/ aPCC*
3. 3-factor PCC + FFP
4. If above unavailable, may consider rVIIa

*The use of aPCC (FEIBA⁷⁰) may be associated with a higher risk of thrombosis compared with nonactivated PCCs¹¹⁰.