Ver el código de «Andexanet alfa»

==Administration==
*Type: factor Xa inhibitor reversal, antidote
*Dosage Forms: solution reconstituted, 100 mg per vial
*Routes of Administration: IV
*Common Trade Names: Andexxa

==Adult Dosing==
===Determined by last dose, type of factor Xa inhibitor, and dose of inhibitor===
*Last dose >8 hours ago
**Low dose
*Last dose <8 hours or unknown
**[[Apixaban]]
***<5 mg: Low dose
***>5 mg/unknown: High dose
**[[Rivaroxaban]]
***<10 mg: Low dose
***>10 mg/unknown: High dose

===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

==Special Populations==
===[[Drug pregnancy categories|Pregnancy Rating]]===
*not known

===Lactation risk===
*not known

===Renal Dosing===
*None
===Hepatic Dosing===
*None

==Contraindications==
*Allergy to class/drug

==Adverse Reactions==
===Serious===
*Arterial and venous thromboembolism
**[[DVT]] (6%)
**[[Ischemic stroke]] (5%)
**[[Myocardial infarction]] (3%)
**[[Pulmonary embolism]] (3%)
*Acute Respiratory failure (1%)
*[[Cardiac arrest]]
*Sudden death

===Common===
*Infusion site reaction
*UTI (5%)
*Pneumonia (5%)

==Pharmacology==
*Half-life: 5 to 7 hours

==Mechanism of Action==
*Binds and sequesters factor Xa inhibitors
*Inhibits the activity of the Tissue Factor Pathway Inhibitor (TFPI), increasing tissue factor-initiated thrombin generation

==Comments==
*FDA approved in May 2018, limited availability June 2018 with broader commercial launch in early 2019
*Cost, $3,300 per 100 mg vial

==See Also==
*[[Apixaban]]
*[[Rivaroxaban]]
*[[Anticoagulant reversal for life-threatening bleeds]]
*[[Rivaroxaban reversal]]

==References==
*Lu, G., DeGuzman, F. R., Hollenbach, S. J., Karbarz, M. J., Abe, K., Lee, G., … Sinha, U. (2013). A specific antidote for reversal of anticoagulation by direct and indirect inhibitors of coagulation factor Xa. Nature Medicine, 19(4), 446–451.
*Andexxa (andexanet alfa) [prescribing information]. South San Francisco, CA: Portola Pharmaceuticals, Inc; May 2018
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[[Category:Pharmacology]]