By rray, 25 March, 2024 Andexanet alfa If last factor Xa inhibitor dose 8h prior give low dose 400 mg bolus at target rate 30 mg min followed by 4 mg min up to 120min If last dose 5 mg apixaban 10 mg rivaroxaban give high dose 800 mg bolus over 30min then 8 mg min x120min Onset
By rray, 25 March, 2024 Give andexanet alfa apixaban rivaroxaban B NR edoxaban C LD or 4F PCC Balfaxar Kcentra C LD to rapidly reverse effects Activated PCC not effective Consider replacement of platelets per ESC
By rray, 25 March, 2024 Peer reviewed & based on multiple guidelines/recommendations from specialty societies/government agencies.
By rray, 25 March, 2024 Active Bleeding on Oral Anticoagulants | 2023 ACC/AHA/ACCP/HRS, 2020 ESC/EACTS, 2020 ACC Guideline Synthesis
By rray, 25 March, 2024 Compress bleeding sites mechanically if accessible Assess hemodynamic status CBC renal fxn and last OAC dose Consider checking anti factor Xa levels not readily available and not needed to treat bleeding NL levels exclude clinically relevant drug levels p
By rray, 22 March, 2024 When triple tx VKA aspirin P2Y12 inhibitor is used an INR of 2 0 2 5 might be reasonable although prospective data are lacking