Andexanet alfa (Andexxa)

• Last Xa Inhibitor dose > 8 hours ago

  • 400 mg IV andexanet alfa bolus at 30 mg/min, followed within 2 minutes by IV infusion of 4 mg/min for up to 120 minutes

• Last Xa Inhibitor dose within past 8 hours

  • Low dose (5 mg or less of apixaban, 10 mg or less of rivaroxaban)

    • 400 mg IV andexanet alfa bolus at 30 mg/min, followed within 2 minutes by IV infusion of 4 mg/min for up to 120 minutes

  • High dose (>5 mg apixaban, >10 mg rivaroxaban) or unknown dose

    • 800 mg IV andexanet alfa bolus at 30 mg/min, followed within 2 minutes by IV infusion of 8 mg/min for up to 120 minutes

Consider hemodialysis

Consider Factor VIIa or Feiba NF (activated PCC) administration for life-threatening bleed