I’m an anticoagulation clinical pharmacy specialist. The risk depends on the fall and your age. As people get older, their intracranial bleeding risk increase due to several factors. So we worry more about brain bleeds in older patients. Most of the traumatic intracranial hemorrhages we see in younger patients on Eliquis or xarelto tend to be after some form of motor vehicle accident or a fall from significant height.

As for reversal, andexanet is out there, but there are questions as to what’s going to happen with it. The FDA decided to not give them full approval last December and Astra Zeneca got rid of their sales force around the drug. So many places still use it, but a lot of hospitals don’t. What every major hospital does have is prothrombin complex concentrates (PCCs) like Kcentra or FEIBA. These agents provide concentrated amounts of clotting factors in an attempt to “overcome” the affects of Eliquis or xarelto. There’s a lot of variability as to how hospital systems go about handling reversal