Pronunciation:
an-dex-a-net al-fa
Trade Name(s)
Ther. Class.
antidotes
Pharm. Class.
clotting factor replacements
To reverse the anticoagulant effect of rivaroxaban or apixaban in patients experiencing life-threatening or uncontrolled bleeding.
Binds to and sequesters rivaroxaban or apixaban, thereby negating their anticoagulant effects. Also inhibits the activity of tissue factor pathway inhibitor, increasing tissue factor-initiated thrombin generation.
Therapeutic Effect(s):
Reversal of the anticoagulant effect of rivaroxaban or apixaban.
Absorption: IV administration results in complete bioavailability.
Distribution: Minimally distributed to tissues.
Metabolism and Excretion: Unknown.
Half-life: Low dose: 3.3 hr; high dose: 2.7 hr.
TIME/ACTION PROFILE (reduction in anti-Factor Xa activity)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
IV | rapid | minutes | 2 hr† |
Contraindicated in:
Use Cautiously in:
CV: DEEP VENOUS THROMBOSIS, MI
Metabolic: infusion reactions
Neuro: STROKE, transient ischemic attack
Resp: PULMONARY EMBOLISM
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
Drug-Drug
None reported.
Low Dose (should be administered if last dose of rivaroxaban ≤10 mg, last dose of apixaban ≤5 mg, or time since patient's last dose (any dose) of rivaroxaban or apixaban ≥8 hr)
IV (Adults): 400 mg IV bolus, followed by 4 mg/min continuous infusion administered for up to 120 min (2 hr).
High Dose (should be administered if last dose of rivaroxaban >10 mg, apixaban >5 mg, or unknown dose AND dose given < 8 hr or at unknown time
IV (Adults): 800 mg IV bolus, followed by 8 mg/min continuous infusion administered for up to 120 min (2 hr).
Lyophilized powder for injection: 200 mg/vial
Reversal of rivaroxaban or apixaban exposes patient to thrombotic risk of their underlying disease; may cause thromboembolism. Monitor for signs and symptoms of thromboembolism (pain, swelling, tenderness in extremities; headache; chest pain; blurred vision) and signs and symptoms that precede cardiac arrest (chest pain, dyspnea, nausea, vomiting, dizziness) and provide treatment as needed. Resume anticoagulant therapy as soon as medically appropriate.
Instruct patient to notify health care professional immediately if signs and symptoms of thromboembolism or cardiac arrest occur.
Reversal of the anticoagulant effect of rivaroxaban or apixaban.