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VARIOUS › ALL OTHER THERAPEUTIC PRODUCTS › ALL OTHER THERAPEUTIC PRODUCTS › Antidotes
andexanet alfa
V03AB38
Forms & Strengths
- Lyophilized powder for reconstitution: 100 mg/vial in single-dose vials
Adult Dosing
- Low-dose: 400 mg IV bolus (target rate ~30 mg/min), followed 2 minutes later by continuous infusion of 4 mg/min for up to 120 minutes
- High-dose: 800 mg IV bolus (target rate ~30 mg/min), followed 2 minutes later by continuous infusion of 8 mg/min for up to 120 minutes
- Dosing selection depends on the specific FXa inhibitor (apixaban or rivaroxaban), dose taken, and time elapsed since the last dose
Pediatric Dosing
- Safety and efficacy have not been established in pediatric patients
Indications
- Reversal of anticoagulation effects of apixaban and rivaroxaban in patients experiencing life-threatening or uncontrolled bleeding
Mechanism of Action
- Recombinant modified human factor Xa decoy protein that binds and sequesters factor Xa inhibitors (apixaban, rivaroxaban), restoring endogenous factor Xa activity
Contraindications
- Known hypersensitivity to andexanet alfa or any of its components
- Severe anaphylactic reactions to prior administration
Adverse Reactions
- Thromboembolic events (stroke, myocardial infarction, deep vein thrombosis, pulmonary embolism)
- Ischemic events
- Cardiac arrest
- Sudden death
- Infusion-related reactions
Drug Interactions
- None formally studied in clinical drug-drug interaction trials
- Concurrent use with other procoagulant agents (e.g., factor IX complex, prothrombin complex concentrate, recombinant factor VIIa) may increase thrombotic risk
Curated Content: Needs Vetting Before Put to Clinical Use