New research published this month shows the grim reality surgeons face when treating brain hemorrhage patients who are taking anticoagulants such as Xarelto. This comes as the makers of the drug are currently embroiled in Xarelto bleeding lawsuits over allegations that the drug is inherently unsafe.

Xarelto is an anticoagulant or blood thinner medication, a type of drug designed to make it harder for blood to clot. In some patients, this can be very important, reducing the chance that certain high-risk patient suffer from strokes or other blood-clot related problems. All anticoagulants carry the risk of uncontrolled bleeding, which can be fatal. However, Xarelto bleeding lawsuits allege that newer anticoagulants are more dangerous than older drugs because they do not have a reversal agent to stop internal bleeding once it starts.

This new study was published in the peer-reviewed medical publication The Journal of Neurosurgery in their August issue. The publication contained new guidelines and guidance on how to treat uncontrolled bleeding in the brain. This can happen when a patient is taking anticoagulants, since the body cannot stop bleeding from very minor injuries. This type of problem can be as dangerous as a stroke, and requires quick medical intervention.

The study first talked about how to handle brain bleeds associated with older anticoagulants like Warfarin. Though still a medical emergency, physicians can effectively shut down this drug’s anticoagulant effects off by administering a high dose of vitamin K quickly. Warfarin and related drugs work by breaking down or interfering with vitamin K, which plays a role in clotting. A very large dose of the vitamin can overwhelm the drug within the body, turning it off in an emergency.

However, when the authors of the paper reached the topic of newer blood thinning medications, they were at something of a loss. Later-generation anticoagulants like Xarelto and Pradaxa work differently than Warfarin. These differences were designed to make the drug more convenient. For example, patients on Warfarin have to avoid foods high in vitamin K, and get regular blood testing. Since Xarelto works on a different chemical pathway, it supposedly does not require these precautions. However, the paper noted that the lack of a known reversal agent greatly complicates treatment with these drugs.

Currently, the makers of Xarelto are facing numerous product liability lawsuits, alleging that the drug in inherently dangerous due to these limitations. These Xarelto lawsuits allege that the makers of the drug were aware—or reasonably should have been aware—of the serious risks associated with this drug. The Xarelto bleeding lawsuits further allege that in spite of these risks, drug makers continued to market these drugs, endangering the public. Xarelto lawsuits typically seek to recoup the cost of medical care, lost wages, legal fees, and other related expenses associated with medical problems allegedly linked to Xarelto.