![]() Thromboembolic and ischemic risks: Arterial and venous thromboembolic events, ischemic events, and cardiac events (including sudden death) were observed within 3 to 30 days postadministration (median time to first event: 7 days). ![]() Anti-factor Xa activity returns to placebo levels ~2 hours after completion of bolus or continuous infusion thereafter, anti-factor Xa activity decreases at a rate similar to the clearance of factor Xa inhibitors. Anti-factor Xa activity re-elevation: There is a rapid and substantial decrease in anti-factor Xa activity corresponding to the bolus dose, which is sustained during the continuous infusion.Timing of Factor Xa Inhibitor Last Dose Before Andexanet alfa Initiation High dose: 800 mg IV bolus administered at a rate of ~30 mg/minute, followed within 2 minutes by an IV infusion of 8 mg/minute for up to 120 minutes.Īndexanet alfa Dose Based on Apixaban or Rivaroxaban Dose Low dose: 400 mg IV bolus administered at a rate of ~30 mg/minute, followed within 2 minutes by an IV infusion of 4 mg/minute for up to 120 minutes. ![]() Resume anticoagulant therapy as soon as medically appropriate following treatment. Life-threatening bleeding associated with apixaban or rivaroxaban: Note: Safety and efficacy of >1 dose of andexanet alfa has not been established. ![]() Life-threatening bleeding associated with edoxaban or betrixaban (off-label use): IV: 800 mg IV bolus administered at a rate of ~30 mg/minute, followed within 2 minutes by an IV infusion of 8 mg/minute for up to 120 minutes (ACC Baugh 2019 Cuker 2019). Life-threatening bleeding associated with factor Xa inhibitors: Note: Generally used for life-threatening bleeding or bleeding into a critical organ that is not controlled with maximal supportive measures (eg, activated charcoal, antifibrinolytic agent) (ACC Baugh 2019 Cuker 2019). ![]()
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