Coagulation factor Xa (recombinant), inactivated-zhzo (andexanet alfa; Andexxa – Portola) has received accelerated approval from the FDA for urgent reversal of the anticoagulant effect of the direct factor Xa inhibitors apixaban (Eliquis) and rivaroxaban (Xarelto). Andexanet alfa is the second antidote for a direct oral anticoagulant to become available in the US, and the first for factor Xa inhibitors. Idarucizumab (Praxbind) was approved in 2015 for reversal of the anticoagulant effect of the direct thrombin inhibitor dabigatran etexilate (Pradaxa).1 Andexanet alfa has not been approved to date for reversal of anticoagulation with the direct factor Xa inhibitors edoxaban (Savaysa)2 or betrixaban (Bevyxxa).3
Andexxa—An Antidote for Apixaban and Rivaroxaban. JAMA. 2018;320(4):399–400. doi:10.1001/jama.2018.9257
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