What about cases of life-threatening bleeding in patients on one of the NOACs?  The 2 potential reversal agents  here are prothrombin complex concentrates (PCCs) or recombinant factor VIIa, although it appears that most physicians in this field are moving toward the PCCs for life-threatening bleeding.[14] 

As seen in Figure 21, the EHRA guidelines also prefer the PCCs.[14]  These will be familiar to the hospital pharmacist or hematologist, who will know what these are and how to use them, and who can provide assistance in cases where a physician is confronted with a patient with a life-threatening bleed on one of the NOACs.  Such a presentation will no doubt be unusual, but physicians must be alert to the possibility and understand how to use these reversal agent choices.