Coagulation Factor Xa Dosage

Medically reviewed by Drugs.com. Last updated on Aug 16, 2023.

Usual Adult Dose for Reversal of Anticoagulation

Reversal of Apixaban Anticoagulation:
Last apixaban dose was 5 mg or less: 400 mg IV bolus at a target rate of 30 mg/min, followed within 2 minutes later by 4 mg/min IV infusion for up to 120 minutes

Last apixaban dose was greater than 5 mg (or unknown) and was administered less than 8 hours (or unknown) ago: 800 mg IV bolus at a target rate of 30 mg/min, followed within 2 minutes later by 8 mg/min IV infusion for up to 120 minutes

Last apixaban dose was greater than 5 mg (or unknown) and was administered at least 8 hours ago: 400 mg IV bolus at a target rate of 30 mg/min, followed within 2 minutes later by 4 mg/min IV infusion for up to 120 minutes

Reversal of Rivaroxaban Anticoagulation:
Last rivaroxaban dose was 10 mg or less: 400 mg IV bolus at a target rate of 30 mg/min, followed within 2 minutes later by 4 mg/min IV infusion for up to 120 minutes

Last rivaroxaban dose was greater than 10 mg (or unknown) and was administered less than 8 hours (or unknown) ago: 800 mg IV bolus at a target rate of 30 mg/min, followed within 2 minutes later by 8 mg/min IV infusion for up to 120 minutes

Last rivaroxaban dose was greater than 10 mg (or unknown) and was administered at least 8 hours ago: 400 mg IV bolus at a target rate of 30 mg/min, followed within 2 minutes later by 4 mg/min IV infusion for up to 120 minutes

Comments:

• The safety and efficacy of an additional dose has not been established.
• Anticoagulant therapy should be resumed as soon as medically appropriate following treatment with this drug.
• This indication is approved under accelerated approval based on the change from baseline in anti-FXa activity in healthy volunteers. Continued approval may depend on the results of studies that demonstrate an improvement in hemostasis.

Use: Reversal of anticoagulation in patients who have been treated with apixaban or rivaroxaban and are experiencing life-threatening or uncontrolled bleeding

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNING:
Thromboembolic Risks, Ischemic Risks, Cardiac Arrest, and Sudden Deaths: Treatment with this drug has been associated with serious and life-threatening adverse events, including arterial and venous thromboembolic events, ischemic events, including myocardial infarction and ischemic stroke, cardiac arrest, and sudden deaths. Monitor for thromboembolic events and initiate anticoagulation when medically appropriate. Monitor for symptoms and signs that precede cardiac arrest and provide treatment as needed.

CONTRAINDICATIONS: None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Prior to administration, carefully inspect for particulate matter and discoloration.
• Administer IV using a 0.2 or 0.22 micron in-line polyether sulfone or equivalent low protein-binding filter.

Storage requirements:

• Unopened vials should be refrigerated at 2 C to 8 C (36 F to 46 F). Do not freeze.
• When reconstituted in vials, may be stored at room temperature for up to 8 hours, or at 2 C to 8 C for up to 24 hours.
• When reconstituted in IV bags, may be stored at room temperature for up to 8 hours, or at 2 C to 8 C for up to 16 hours.

Reconstitution/preparation techniques: The manufacturer product information should be consulted.

General:

• This drug is not effective or indicated for treating bleeding related to any FXa inhibitors other than apixaban or rivaroxaban.

Monitoring:

• Cardiovascular: Arterial and venous thromboembolic events, ischemic events, and cardiac arrest

Patient Advice:

• Arterial and venous thromboembolic events, ischemic events, cardiac events, and sudden death were observed within 30 days after administration of this drug.
• Reversing FXa inhibitor therapy may increase the risk of thromboembolic events.

See also:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer