New Research => Reversal agent for new blood thinners => Andexanet
Suspect acute bleeding in a patient is taking one of the following medications???
- Rivaroxiban (Xarelto)
- Apixaban (Eliquis)
- Enoxaparin (Lovenox)
– The Christ Hospital now has the following treatment available through the Annexa Study –
Andexanet
- This drug is a reversal agent for Factor Xa inhibitors, a new class of anticoagulants
- It is used to immediately reverse anticoagulation in patients with ACUTE BLEEDING
- Reversal of anticoagulation in the event of an acute bleeding episode shows a reduction in mortality
- Acute bleeding that is potentially life threatening includes:
- GI bleeds
- Intracranial hemorrhage
- Intraspinal, retroperitoneal or intramuscular with compartment syndrome
- Bleeding associated with a drop in the Hb level >2g/dL or a Hb < 8g/dL
- The study drug must be started within 18 hours of the last dose of Factor Xa inhibitors
- Patients will receive an IV bolus of Andexanet followed by a 2 hour infusion
- The most common side effect is a mild transfusion reaction (sensation of warmth, flushing, palpitations) which generally last only minutes and subsides without intervention
How can EMS assist in this process?
- By identifying patients with ACUTE BLEEDING episodes who are taking:
- Rivaroxiban (Xarelto)
- Apixaban (Eliquis)
- Enoxaparin (Lovenox)
- Document the drug name, time of last dose, and amount of last dose
- If possible, notify the Emergency Department so that they can call the Research Team