Formulary
Andexanet alfa: Indications, Dosing, Side Effects and Interactions
Andexanet alfa is a recombinant form of human factor X a protein which binds specifically to apixaban or rivaroxaban, thereby reversing their anticoagulant...
MedNext Academy | 3 min read
Andexanet alfa: Indications, Dosing, Side Effects and Interactions
Andexanet alfa is a recombinant form of human factor X a protein which binds specifically to apixaban or rivaroxaban, thereby reversing their anticoagulant...
Drug action
Andexanet alfa is a recombinant form of human factor X a protein which binds specifically to apixaban or rivaroxaban, thereby reversing their anticoagulant effects.
Indications and dose
**Reversal of apixaban or rivaroxaban in life-threatening or uncontrolled bleeding (specialist supervision in hospital)**
- **Adult** (By Intravenous Infusion): (consult product literature).
Cautions
Risk of thrombosis Cautions, further information Manufacturer advises to consider re-starting anticoagulant therapy as soon as medically appropriate to reduce the risk of thrombosis.
Side effects
Common or very common Back pain; cerebrovascular insufficiency; chest discomfort; cough; dizziness postural; dry mouth; dyspnoea; embolism and thrombosis; feeling hot; fever; flushing; gastrointestinal discomfort; headache; hyperhidrosis; muscle spasms; myocardial infarction; nausea; palpitations; peripheral coldness; skin reactions; taste altered Uncommon Cardiac arrest; iliac artery occlusion
Interactions
**Other interactions (4):**
- In vitro data suggest interaction of andexanet alfa with the heparin- anti-thrombin III (ATIII) complex and neutralisation of the anticoagulant effect of heparin.
- Off-label use of andexanet alfa pre-surgery, intra-operatively, or during procedures requiring heparinisation has been reported to cause unresponsiveness to heparin (see section 4.4).
- Based on PK/PD modelling, the anticoagulant activity of low molecular weight heparin may be affected up to 4 hours following end of infusion with andexanet alfa (see section 5.1).
- Use of andexanet alfa as an antidote for heparin or low-molecular weight heparin has not been evaluated and is not recommended.
Pregnancy
Manufacturer advises avoid-no information available.
Breast feeding
Manufacturer advises discontinue breast-feeding-no information available.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Andexanet alfa in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

