A specific antidote for reversal of anticoagulation by direct and indirect inhibitors of coagulation factor Xa. Anticoagulant reversal for life-threatening bleeds.FDA approved in May 2018, limited availability June 2018 with broader commercial launch in early 2019.

Inhibits the activity of the Tissue Factor Pathway Inhibitor (TFPI), increasing tissue factor-initiated thrombin generation.Binds and sequesters factor Xa inhibitors 12 CLINICAL PHARMACOLOGY, 12.1 Mechanism of Action, 12.2 Pharmacodynamics, 12.3 Pharmacokinetics, 13 NONCLINICAL TOXICOLOGY, 13.1 Carcinogenesis. Mechanism of Action Andexanet alfa acts as a decoy and sequesters rivaroxaban or apixaban, inhibiting them from binding to natural factor Xa.Dosage Forms: solution reconstituted, 100 mg per vialĪdult Dosing Determined by last dose, type of factor Xa inhibitor, and dose of inhibitorĤ00 mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by 4 mg/minute for up to 120 minutesĨ00 mg IV bolus at rate of ~30 mg/minute, followed 2 minutes later by 8 mg/minute for up to 120 minutes.Type: factor Xa inhibitor reversal, antidote.2.1 Determined by last dose, type of factor Xa inhibitor, and dose of inhibitor.In comparison to factor Xa, which contains serine, andexanet alfa contains alanine as its active-site residue and lacks a membrane-binding domain. Refer to Section 1.1 of the Clinical Review Memo for information about participation in the clinical trials and any analysis of demographic subgroup outcomes that is notable. MECHANISM OF ACTION Andexanet alfa is an engineered variant of factor Xa, whose similarity to the human form allows it to bind factor Xa inhibitors with high affinity.

Demographic Subgroup Information - coagulation factor Xa (recombinant), inactivated-zhzo.

The drug can also bind and inhibit the activity of tissue-factor pathway inhibitor, which can increase thrombin generation and ultimately promote a procoagulant state.

Indicated for patients treated with rivaroxaban and apixaban, when reversal of anticoagulation is needed due to life-theratening or uncontrolled bleeding This study described the mechanism of action: spike protein impairs endothelial function via downregulation of ACE2 (Ref2 DOI: 10.1161/CIRCRESAHA.121.318902). MECHANISM OF ACTION Andexanet alfa's procoagulant effects are achieved through the ability to bind and sequester Direct factor Xa inhibitors - Wikipedia.

Manufacturer: Alexion Pharmaceuticals, Inc. Proper Name: coagulation factor Xa (recombinant), inactivated-zhzo

Andexxa mechanism of action