Direct Factor Xa Inhibitors

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Direct Factor Xa Inhibitors

  • Examples: This class of drugs includes rivaroxaban and apixaban. These drugs are administered orally.
  • Mechanism of action: These drugs bind to factor Xa, resulting in the direct inhibition of Xa. Once factor Xa is inhibited, it cannot function in the coagulation cascade and the fibrin clot cannot form.
  • Use: Direct Factor Xa Inhibitors are used in the chronic management of hypercoagulability.
  • Laboratory measurement: These drugs do not require routine laboratory monitoring. Please see the following link if you wish to obtain more in-depth knowledge on how these medications affect coagulation testing: http://emj.bmj.com/content/emermed/early/2015/05/17/emermed-2015-204891.full.pdf
  • Toxicity: All anticoagulants can cause excessive bleeding, but there is not a reversal agent for this class of medications. PCC does provide a partial reversal of these drugs, however.