Template:Factor Xa Inhibitor Reversal - Revision history

Gpowellhb: /* Andexanet alfa */

2020-02-11T22:03:18Z

Andexanet alfa

← Revisión anterior		Revisión del 22:03 11 feb 2020
Línea 22:		Línea 22:
	===[[Andexanet alfa]]===		===[[Andexanet alfa]]===
	FDA approved in May 2018, limited availability June 2018		FDA approved in May 2018, limited availability June 2018

			*Cost is $20,000 to $55,000 per dose
			*Trial that led to FDA approval does not have the most sound evidence behind it <ref>Connolly SJ, Crowther M, Eikelboom JW, et al. Full Study Report of Andexanet Alfa for Bleeding Associated with Factor Xa Inhibitors. N Engl J Med. 2019</ref>:
			**Prospective single center single group study of 352 patients receiving a Factor Xa Inhibitor ([[apixaban]], [[rivaroxaban]], [[edoxaban]], [[enoxaparin]]) with life threatening bleed (those with expected survival <1 month were excluded).
			**Anti-Factor Xa activity was decreased in all groups. 82% were judged to have excellent hemostatic control. 14% mortality rate at 30 days.
			**No comparison group available. It is unlikely that following anti-Factor Xa activity as a lab value is clinically important. High mortality rate even after excluding sick patients.


	====Low 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		'''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====		====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		'''800''' mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by '''8''' mg/minute for up to 120 minutes

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2020-01-06T23:16:20Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 23:16 6 ene 2020
Línea 6:		Línea 6:
	\| align="center" style="background:#f0f0f0;"\|'''Strategies to reverse or minimize anticoagulant effects'''		\| align="center" style="background:#f0f0f0;"\|'''Strategies to reverse or minimize anticoagulant effects'''
	\|-		\|-
	\| [[Apixaban]]<ref>*Eliquis prescribing information. Princeton, NJ: Bristol Myers Squibb; December 2012.</ref> (Eliquis®)\|\|8-15 hrs (longer in renal impairment)\|\|No\|\|		\| [[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™)^
Línea 12:		Línea 12:
	**50 units/kg—max 5000 units for all other life-threatening bleeds		**50 units/kg—max 5000 units for all other life-threatening bleeds
	\|-		\|-
	\| [[Edoxaban]]<ref>*Savaysa prescribing information. Parsippany, NJ: Daiichi Sankyo, Inc.; November 2015.</ref> (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|As above		\| [[Edoxaban]]<ref>Savaysa prescribing information. Parsippany, NJ: Daiichi Sankyo, Inc.; November 2015.</ref> (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|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		\| [[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

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2020-01-06T23:15:10Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 23:15 6 ene 2020
Línea 12:		Línea 12:
	**50 units/kg—max 5000 units for all other life-threatening bleeds		**50 units/kg—max 5000 units for all other life-threatening bleeds
	\|-		\|-
	\| [[Edoxaban]] (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|As above		\| [[Edoxaban]]<ref>*Savaysa prescribing information. Parsippany, NJ: Daiichi Sankyo, Inc.; November 2015.</ref> (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|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		\| [[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

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2020-01-06T23:14:18Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 23:14 6 ene 2020
Línea 6:		Línea 6:
	\| align="center" style="background:#f0f0f0;"\|'''Strategies to reverse or minimize anticoagulant effects'''		\| align="center" style="background:#f0f0f0;"\|'''Strategies to reverse or minimize anticoagulant effects'''
	\|-		\|-
	\| [[Apixaban]] (Eliquis®)\|\|8-15 hrs (longer in renal impairment)\|\|No\|\|		\| [[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™)^

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2020-01-06T23:12:19Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 23:12 6 ene 2020
Línea 14:		Línea 14:
	\| [[Edoxaban]] (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|As above		\| [[Edoxaban]] (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|As above
	\|-		\|-
	\| [[Rivaroxaban reversal\|Rivaroxaban]] (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
	\|-		\|-
	\| [[Fondaparinux]] (Arixtra®)\|\|17-21 hrs (significantly longer in renal impairment)\|\|No\|\|4-factor [[PCC]] (Kcentra™)^ 50 units/kg—max 5000 units		\| [[Fondaparinux]] (Arixtra®)\|\|17-21 hrs (significantly longer in renal impairment)\|\|No\|\|4-factor [[PCC]] (Kcentra™)^ 50 units/kg—max 5000 units

Mrosen5506: /* Factor Xa Inhibitor Reversal */

2018-08-11T19:47:25Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 19:47 11 ago 2018
Línea 19:		Línea 19:
	\|}		\|}
	^Off-label		^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

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2016-09-24T10:53:14Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 10:53 24 sep 2016
Línea 8:		Línea 8:
	\| [[Apixaban]] (Eliquis®)\|\|8-15 hrs (longer in renal impairment)\|\|No\|\|		\| [[Apixaban]] (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™)^
	**25units/kg—max 2500 units for treatment of documented intracranial hemorrhage		**25units/kg—max 2500 units for treatment of documented intracranial hemorrhage
	**50 units/kg—max 5000 units for all other life-threatening bleeds		**50 units/kg—max 5000 units for all other life-threatening bleeds

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2016-04-28T13:15:39Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 13:15 28 abr 2016
Línea 1:		Línea 1:
	===Factor Xa Inhibitor Reversal===		===[[Anticoagulant reversal for life-threatening bleeds\|Factor Xa Inhibitor Reversal]]===
	{\| {{table}}		{\| {{table}}
	\| align="center" style="background:#f0f0f0;"\|'''Anticoagulant'''		\| align="center" style="background:#f0f0f0;"\|'''Anticoagulant'''

Rossdonaldson1: /* Factor Xa Inhibitor Reversal */

2016-04-28T13:13:42Z

Factor Xa Inhibitor Reversal

← Revisión anterior		Revisión del 13:13 28 abr 2016
Línea 14:		Línea 14:
	\| [[Edoxaban]] (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|As above		\| [[Edoxaban]] (Savaysa®)\|\|10-14 hrs (longer in renal impairment)\|\|~ 25%\|\|As above
	\|-		\|-
	\| [[Rivaroxaban]] (Xarelto®)\|\|9-13 hrs (longer in renal impairment)\|\|No\|\|As above		\| [[Rivaroxaban reversal\|Rivaroxaban]] (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		\| [[Fondaparinux]] (Arixtra®)\|\|17-21 hrs (significantly longer in renal impairment)\|\|No\|\|4-factor [[PCC]] (Kcentra™)^ 50 units/kg—max 5000 units
	\|}		\|}
	^Off-label		^Off-label

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2016-04-28T13:13:03Z

Created page with "===Factor Xa Inhibitor Reversal=== {| {{table}} | align="center" style="background:#f0f0f0;"|'''Anticoagulant''' | align="center" style="background:#f0f0f0;"|'''Half-life''' |..."

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===Factor Xa Inhibitor Reversal===
{| {{table}}
| align="center" style="background:#f0f0f0;"|'''Anticoagulant'''
| align="center" style="background:#f0f0f0;"|'''Half-life'''
| align="center" style="background:#f0f0f0;"|'''Removed by HD'''
| align="center" style="background:#f0f0f0;"|'''Strategies to reverse or minimize anticoagulant effects'''
|-
| [[Apixaban]] (Eliquis®)||8-15 hrs (longer in renal impairment)||No||
*If ingested within 2 hours, administer activated charcoal
*4-factor PCC (Kcentra™)^
**25units/kg—max 2500 units for treatment of documented intracranial hemorrhage
**50 units/kg—max 5000 units for all other life-threatening bleeds
|-
| [[Edoxaban]] (Savaysa®)||10-14 hrs (longer in renal impairment)||~ 25%||As above
|-
| [[Rivaroxaban]] (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