![]() Andexanet Alfa (Andexxa (R)) for the Reversal of Direct Oral Anticoagulants.PT. Andexanet alfa for reversing anticoagulation from apixaban or rivaroxaban also andexanet alfa has the ability to inhibit tissue-factor pathway inhibitor, which is maintained for at least 22 hours following andexanet alfa's administration.reduced anti-factor Xa activity remains for up to two hours following discontinuation of the infusion.initial reduction in anti-factor Xa activity and regeneration of normal thrombin levels occur within two minutes of IV bolus-dose administration.administration of an intravenous (IV) bolus dose of andexanet alfa followed by a two-hour continuous IV infusion resulted in a rapid decrease of anti-factor Xa activity.11 Prospective and retrospective studies in adults have been completed using andexanet alfa and PCC for the reversal. 10 It is a recombinant enzymatically inactive factor Xa decoy protein that has higher binding affinity for DXIs than does natural factor Xa. drug can also bind and inhibit the activity of tissue-factor pathway inhibitor, which can increase thrombin generation and ultimately promote a procoagulant state Andexanet alfa received FDA approval for use in adults in need of DXI reversal in 2018.andexanet alfa's procoagulant effects are achieved through the ability to bind and sequester factor Xa inhibitors.allows andexanet alfa to successfully bind factor Xa inhibitors without promoting further anticoagulant activity.in comparison to factor Xa, which contains serine, andexanet alfa contains alanine as its active-site residue and lacks a membrane-binding domain. ![]() an engineered variant of factor Xa, whose similarity to the human form allows it to bind factor Xa inhibitors with high affinity.the company provides andexanet alfa according to the commercial arrangement.the bleed is in the gastrointestinal tract, and.Last edited 05/2021 and last reviewed 07/2021Īndexanet alfa is recommended as an option for reversing anticoagulation from apixaban or rivaroxaban in adults with life-threatening or uncontrolled bleeding, only if (1): Patients taking <10 mg of rivaroxaban or <5 mg of apixaban per dose should receive the low-dose regimen, a 400-mg IV bolus dose of andexanet alfa over 1530.
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