Ecarin based coagulation testing

Robert C Gosselin, Jonathan Douxfils

Research output: Contribution to journalReview articlepeer-review

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Ecarin is derived from venom of Echis carinatus, and will activate prothrombin into meizothrombin which will then cleave fibrinogen to result in clot formation. Ecarin based testing has been described for decades, but these assays were typically restricted to reference or speciality coagulation laboratories. This test was initially described for the assessment of direct thrombin inhibitors (eg, bivalirudin lepirudin, or argatroban) and was not affected by heparins or heparinoids. Ecarin based assays were rarely used for anticoagulation monitoring until the emergence of the direct oral thrombin inhibitor dabigatran etexilate in 2010. As this test was mentioned in the prescribing information for dabigatran etexilate, there was increased interest for use by clinical laboratories as the preferred method for assessing the anticoagulant effect of this drug. The purpose of this document is to review the current status of ecarin based assays for assessing dabigatran. This is with the understanding that these methods can also be exploited for determining the anticoagulation effect of parenteral direct thrombin inhibitors, such as argatroban and bivalirudin.

Original languageEnglish
Pages (from-to)863-869
Number of pages7
Journal European Medical Journal Hematology
Issue number7
Early online date19 Apr 2020
Publication statusPublished - 1 Jul 2020


  • Antithrombins/pharmacokinetics
  • Blood Coagulation Tests
  • Dabigatran/pharmacokinetics
  • Drug Monitoring
  • Endopeptidases/chemistry
  • Humans


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