Although using direct oral anticoagulants increases patient risk for hemorrhagic events, FDA-approved options for reversing anticoagulant effects are limited. This article discusses one of the more recent FDA-approved antidotes, andexanet alfa, and provides guidelines for its safe and effective use.
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http://dx.doi.org/10.1097/01.JAA.0000723956.47623.90 | DOI Listing |
Thromb Res
January 2025
Neurology and Stroke Unit, AORN "Antonio Cardarelli", Naples, Italy. Electronic address:
Cureus
November 2024
Cardiothoracic Surgery, Mater Misericordiae University Hospital, Dublin, IRL.
A 61-year-old man in critical condition was admitted to the resuscitation room in the emergency department, presenting with chest pain and shortness of breath. His medical history included recent treatment with oral antibiotics for pneumonia, long-standing chronic obstructive pulmonary disease (COPD), a 40-pack-year smoking history, and a left popliteal artery embolus. He was also on chronic medications, including apixaban and aspirin.
View Article and Find Full Text PDFHematology Am Soc Hematol Educ Program
December 2024
Departments of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC.
J Neurosurg Case Lessons
December 2024
Department of Pharmacy Services, University of Cincinnati Medical Center, Cincinnati, Ohio.
Background: The management of rivaroxaban overdose in severe traumatic brain injury (sTBI) is undocumented. Reversal with andexanet alfa (AA) and prothrombin complex concentrates (PCCs) in cases of supratherapeutic doses remains unproven. Management is further complicated by the absence of real-time serum rivaroxaban concentration assays and drug-specific coagulation assays.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department of Anesthesiology, University Hospital RWTH Aachen, 52074 Aachen, Germany.
Andexanet alfa is a specific antidote for factor Xa (FXa) inhibitors. It is licensed to treat patients under FXa inhibitor therapy with life-threatening bleeding. Concomitantly, volume expanders are used to compensate for blood loss and maintain circulation.
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