Andexanet alfa versus four-factor prothrombin complex concentrate for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage: a propensity score-overlap weighted analysis. Thirty-day mortality with andexanet alfa compared with prothrombin complex concentrate therapy for life-threatening direct oral anticoagulant-related bleeding. Apixaban > 5 mg / Unknown High Dose Andexanet alfa Dose Initial IV Bolus Follow-On IV Infusion Low Dose 400 mg over 15 minutes 480mg (Infuse at 4 mg/min over 120 minutes) High Dose 800 mg over 30 minutes 960mg (Infuse at 8 mg/min over 120 minutes) The safety and efficacy of more than one dose have not been evaluated. Andexanet alfa and four-factor prothrombin complex concentrate for reversal of apixaban and rivaroxaban in patients diagnosed with intracranial hemorrhage. 1 There are no randomised clinical trials as of 2019.

Vestal ML, Hodulik K, Mando-Vandrick J, et al. Andexanet alfa is used to stop life-threatening or uncontrollable bleeding in people who are taking rivaroxaban or apixaban. All reported lower rates of 30-day all-cause mortality in andexanet alfa-recipients compared to 4F-PCC-recipients the reported 30-day all-cause mortality ranged approximately from 7.9 to 30.0% in andexanet alfa as opposed to 19.6 to 48.9% in 4F-PCC groups in this cohort of patients. Recent studies have examined andexanet alfa versus four-factor thrombin complex concentrate (4F-PCC) for reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage.

Andexanet alfa dosing