A specific antidote for reversal of anticoagulation by direct and indirect inhibitors of coagulation factor Xa.
Anticoagulant reversal for life-threatening bleeds. FDA approved in May 2018, limited availability June 2018 with broader commercial launch in early 2019. Inhibits the activity of the Tissue Factor Pathway Inhibitor (TFPI), increasing tissue factor-initiated thrombin generation. Binds and sequesters factor Xa inhibitors. Dosage Forms: solution reconstituted, 100 mg per vialĪdult Dosing Determined by last dose, type of factor Xa inhibitor, and dose of inhibitorĤ00 mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by 4 mg/minute for up to 120 minutesĨ00 mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by 8 mg/minute for up to 120 minutes. Type: factor Xa inhibitor reversal, antidote. 2.1 Determined by last dose, type of factor Xa inhibitor, and dose of inhibitor. Once andexanet alfa has been administered please complete this form as soon as possible. Dedicated syringe pumps with the loading and maintenance rates pre-programmed are available in each location andexanet is stocked, but as an additional safety measure these should be checked against the table below.ġ60mL/hour (over 30 minutes each syringe will run for 15 minutes each)Ĥ8mL/hr (over 2 hours each syringe will run for 60 minutes each) Indicated for patients treated with rivaroxaban and apixaban, when reversal of anticoagulation is needed because of life-threatening or uncontrolled bleeding. Andexanet alfa comes as a 200mg/20mL vial (pack size of 4 vials). 
The volume, doses and rates required for each regimen is detailed below. Timing of last dose before andexanet alfa administration High dose regimen = 800mg loading dose followed by 960mg over 2 hours. How to reconstitute ANDEXXA IV bolus preparation 1 Reconstitute the 200-mg vial of ANDEXXA with 20 mL of Sterile Water for Injection (SWFI). Low dose regimen = 400mg loading dose followed by 480mg over 2 hours. See full administration guide for further details. Both are given as an initial loading dose (15 to 30 minutes) followed by a 2 hour infusion. Patients should receive either a LOW DOSE or HIGH DOSE regimen depending on the time/dose of their last oral anticoagulant. It is used to reverse the effects of rivaroxaban or apixaban in life-threatening or uncontrolled bleeding. Andexanet alfa must only be administered on the advice of a Consultant Haematologist.
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