There are no recommendations for dose adjustments due to renal or hepatic dysfunction.

The safety and efficacy of repeat treatment with andexanet alfa has not been established.

Within 2 minutes following the IV bolus, administer the continuous IV infusion for up to 120 minutes.

Administer the IV bolus dose at approximately 30 mg/min.

Administer through a 0.2-0.22 micron in-line polyethersulfone or equivalent low protein-binding filter.

After reconstitution, andexanet alfa must be used within 8 hours at room temperature.

(The safety and efficacy of more than one dose have not been evaluated.) Andexanet Alfa Dose Based on Rivaroxaban or Apixaban Dose (Timing of FXa Inhibitor Last Dose Before Andexanet Alfa Initiation) FXa Inhibitor

The safety and efficacy of repeated doses of andexanet alfa have not been established.īased on the last dose and timing of rivaroxaban or apixaban there is a Low Dose and High Dose regimen of andexanet alfa.

Clinical trials suggest peak anti-Xa activity at 4 hours after infusion, then decrease at a rate similar to clearance of the factor Xa inhibitor.

Anti-Xa activity can rebound after completing the infusion of andexanet alfa.

Andexanet alfa will likely correct anti-Xa values, but the correlation of lab results with improved clinical outcomes has not been established.

Monitor for signs/symptoms of clinically relevant bleeding and thromboembolic events.

Prior to use, assess the patient for recent administration of rivaroxaban or apixaban.

Andexanet alfa may have “off-target” prothrombotic effects, possibly resulting from its effects on Tissue Factor Pathway Inhibitor (TFPI).Īpproved for reversal of the anticoagulant effect rivaroxaban and apixaban in the setting of life-threatening bleeding.

Andexanet Alfa Dose Based on Rivaroxaban or Apixaban Dose (Timing of FXa Inhibitor Last Dose Before Andexanet Alfa Initiation)Ī recombinant modified human coagulation factor Xa that binds to and sequesters factor Xa inhibitors (such as rivaroxaban and apixaban) to neutralize their anticoagulant effects as measured by anti-Xa activity.

Andexxa drug