Antidote: andexanet alfa
At the time of writing, there is no evidence evaluating the safety or efficacy of the antidote andexanet andexanet alfa1 (a recombinant inactive factor Xa decoy molecule) for apixaban or rivaroxaban poisoning. Andexanet alfa provides no benefit in the absence of bleeding, and most patients with apixaban and rivaroxaban poisoning will not have concomitant bleeding. In addition, the optimal dosage regimen in the context of poisoning is unknown. If a patient presents with apixaban or rivaroxaban poisoning and concomitant bleeding, seek urgent advice from a clinical toxicologistBekka 2024.
1 Andexanet alfa is provisionally approved by the
Australian Therapeutic Goods Administration (TGA) for reversal of anticoagulation
in patients with life-threatening or uncontrolled bleeding due to apixaban or
rivaroxaban; see the TGA website for current information about registration.Return