What general principles should be employed when managing NOAC-related bleeding?
When managing NOAC-related bleeding, a helpful framework to consider is to include: (1) prevention of bleeding, (2) general principles and supportive measures, (3) nonspecific hemostatic agents, and (4) NOAC-specific reversal. The most important step to minimize bleeding risk is to select the right dose of the NOAC. Prescribing information for all NOACs includes dose reduction criteria to avoid increased drug exposure (primarily due to impaired renal function).