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Apixaban Reversal

Apixaban Reversal

About apixaban reversal

apixaban reversal alfa, the first agent shown to reverse the anticoagulant effects of rivaroxaban and apixaban, has been approved by the FDA, according to a May 3 statement from Portola Pharmaceuticals.

It is approved for use in patients treated with these factor Xa inhibitors when reversal of anticoagulation is needed because of life-threatening or uncontrolled bleeding, according to the company.

What are the uses for apixaban reversal ?

Apixaban is used for reducing the risk of blood clots in the heart and strokes in patients with atrial fibrillation who have no problems with their heart valves (nonvalvular atrial fibrillation).

It also is used for treating and preventing deep venous thrombosis (DVT) and pulmonary embolism in patients who have undergone hip or knee replacement surgery.


apixaban reversal is an anticoagulant (blood thinner) that reduces blood clotting and reduces the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.

Apixaban is available under the following different brand names: Eliquis.

What are the side effects of apixaban?

The most common side effects of apixaban involves bleeding in the:

  • stomach,
  • intestines,
  • brain, and
  • eyes.

What is the dosage for apixaban reversal?

The usual dose in nonvalvular atrial fibrillation is 5 mg by mouth twice daily. For individuals 80 years or older, weighing less than or equal to 60 kg, or with reduced kidney function, the usual dose is 2.5 mg twice daily.

The recommended dose for treating DVT or pulmonary embolism is 10 mg twice daily for the first 7 days and then 5 mg twice daily. After six months of treatment, the dose may be reduced to 2.5 mg daily for prevention of DVT or pulmonary embolism.

When apixaban is used to prevent the risk of DVT after hip or knee replacement surgery, the suggested dose is 2.5 mg daily beginning 12 to 24 hours after the surgery is completed.

FDA Clears First Reversal Agent for Rivaroxaban, Apixaban Anticoagulants

FDA designated this agent as a break-through treatment of patients hospitalized with life-threatening bleeding who take factor Xa drugs.

Andexxa (coagulation factor Xa [recombinant], inactivated-zhzo) received both U.S. orphan drug and FDA breakthrough therapy designations and was approved under the FDA's accelerated approval pathway based on the change from baseline in anti-factor Xa activity in healthy volunteers. Continued approval for this indication may be contingent upon post-marketing study results to demonstrate an improvement in hemostasis in patients.


ELIQUIS is indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.

ELIQUIS is indicated for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.

ELIQUIS is indicated for the treatment of DVT and PE, and to reduce the risk of recurrent DVT and PE following initial therapy.


Based on an interim analysis of an ongoing single-arm trial, andexanet alfa (Andexxa) can rapidly reverse the anticoagulant effect of apixaban (Eliquis), rivaroxaban (Xarelto), and (off-label) enoxaparin (Lovenox, and generics) in patients with active major bleeding. It should also be effective in reversing the anticoagulant effect of other direct factor Xa inhibitors such as edoxaban (Savaysa) and indirect factor Xa inhibitors such as fondaparinux (Arixtra, and generics), but data are lacking. How andexanet alfa compares with prothrombin complex concentrates, which cost much less, remains to be determined.

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