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AndexXa

Posted by Mark 
AndexXa
August 10, 2021 11:54PM
AndexXa is the antedidote/reversal agent for Eliquis which I suspect is used in emergency-like situations. I’m told by my EP that it is expensive but that most larger emergency rooms have it on hand. Anyone have any experience with it?
Re: AndexXa
August 11, 2021 11:53AM
You're unlikely to find anyone who has experience with it because it's rarely if ever used. Even major trauma centers rarely use it because the half-life of Eliquis and the other NOACs is so short that it's rarely needed (about 12 hours or less). I listened to a trauma surgeon from NYU Medical Center discussing this recently and he said of the thousands of trauma patients he's treated at NYU who were on Eliquis or other NOACs, he had never administered a single dose of the reversal agent.

Compare this to warfarin, which has a half-life measured in days (a full week, actually, but effectively it's about two days). That's why it was important for there to be a reversal agent for warfarin, but the same isn't really true for the NOACs. In an uncontrolled bleeding situation with Eliquis they can generally just wait for the drug to wear off, or give you fresh frozen plasma instead, which is much cheaper, readily available, and works instantly.
Re: AndexXa
August 11, 2021 10:50PM
Really good information. Thanks.
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