Andexanet Alfa

Products

Andexanet alfa was approved in the United States in 2018, in the EU in 2019, and in many countries in 2020 as a powder for the preparation of an infusion solution (Ondexxya).

Structure and properties

Andexanet alfa is a recombinant, modified, and enzymatically inactive factor Xa. The drug is produced by biotechnological methods.

Effects

Andexanet alfa (ATC V03AB38) binds factor Xa inhibitors, thereby abolishing their anticoagulant effects. It prevents the agents from interacting with and inhibiting natural factor Xa. The half-life ranges from 4 to 7 hours.

Indications

For use in adult patients treated with a direct factor Xa inhibitor (apixaban or rivaroxaban) when discontinuation of anticoagulation is required due to life-threatening or uncontrollable bleeding.

Dosage

According to the SmPC. The drug is administered as an intravenous infusion.

Contraindications

  • Hypersensitivity

For complete precautions, see the drug label.

Interactions

Andexanet alfa may reverse the anticoagulant effect of heparin by interacting with the heparin-anti-thrombin III complex.

Adverse effects

The most common potential adverse effects include mild to moderate infusion-related reactions. Severe adverse reactions may occur, for example, myocardial infarction or stroke.