Template:Factor Xa Inhibitor Reversal: Difference between revisions
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| align="center" style="background:#f0f0f0;"|'''Strategies to reverse or minimize anticoagulant effects''' | | align="center" style="background:#f0f0f0;"|'''Strategies to reverse or minimize anticoagulant effects''' | ||
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| [[Apixaban]]<ref> | | [[Apixaban]]<ref>Eliquis prescribing information. Princeton, NJ: Bristol Myers Squibb; December 2012.</ref> (Eliquis®)||8-15 hrs (longer in renal impairment)||No|| | ||
*If ingested within 2 hours, administer activated charcoal | *If ingested within 2 hours, administer activated charcoal | ||
*4-factor [[PCC]] (Kcentra™)^ | *4-factor [[PCC]] (Kcentra™)^ | ||
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**50 units/kg—max 5000 units for all other life-threatening bleeds | **50 units/kg—max 5000 units for all other life-threatening bleeds | ||
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| [[Edoxaban]]<ref> | | [[Edoxaban]]<ref>Savaysa prescribing information. Parsippany, NJ: Daiichi Sankyo, Inc.; November 2015.</ref> (Savaysa®)||10-14 hrs (longer in renal impairment)||~ 25%||As above | ||
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| [[Rivaroxaban reversal|Rivaroxaban]]<ref>Xarelto prescribing information. Titusville, NJ: Janssen Pharmaceuticals, Inc.; December 2014.</ref> (Xarelto®)||9-13 hrs (longer in renal impairment)||No||As above | | [[Rivaroxaban reversal|Rivaroxaban]]<ref>Xarelto prescribing information. Titusville, NJ: Janssen Pharmaceuticals, Inc.; December 2014.</ref> (Xarelto®)||9-13 hrs (longer in renal impairment)||No||As above | ||
Revision as of 23:16, 6 January 2020
Factor Xa Inhibitor Reversal
| Anticoagulant | Half-life | Removed by HD | Strategies to reverse or minimize anticoagulant effects |
| Apixaban[1] (Eliquis®) | 8-15 hrs (longer in renal impairment) | No |
|
| Edoxaban[2] (Savaysa®) | 10-14 hrs (longer in renal impairment) | ~ 25% | As above |
| Rivaroxaban[3] (Xarelto®) | 9-13 hrs (longer in renal impairment) | No | As above |
| Fondaparinux (Arixtra®) | 17-21 hrs (significantly longer in renal impairment) | No | 4-factor PCC (Kcentra™)^ 50 units/kg—max 5000 units |
^Off-label
Andexanet alfa
FDA approved in May 2018, limited availability June 2018
Low Dose
400 mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by 4 mg/minute for up to 120 minutes
High Dose
800 mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by 8 mg/minute for up to 120 minutes