The direct oral anticoagulants (DOACs) including dabigatran, apixaban, and rivaroxaban are safe and effective alternatives to warfarin among patients with thromboembolism and nonvalvular atrial fibrillation, as demonstrated in RE-LY, AMPLIFY, ROCKET AF, and other large trials. In this single-arm trial, andexanet alfa administration decreased anti-Xa activity and achieved hemostasis in a majority of patients, and was associated with a high rate of thrombosis and death. 39(9):2644-91, 2008 Sep.In adults with potentially life-threatening acute major bleeding, what is the efficacy and safety of andexanet alfa for reversing the anticoagulant effects of the factor Xa inhibitors apixaban, rivaroxaban, edoxaban, or enoxaparin? Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Council on Cardiovascular Disease in the Young.

American Heart Association Stroke Council. Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Monagle P, Chan AKC, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-Gottl U, Vesely SK. Lexi-Drugs Online/Pediatric Lexi-Drugs Online, Enoxaparin,, Copyright © 1978-2008 Lexi-Comp, Inc, Hudson, OH 44236 Patients with hypersensitivity to fish (vertibrate, not shellfish) and those who have received protamine-containing insulin or previous protamine therapy may be at risk of hypersensitivity reactions.ĭavid, M., et al. More rapid infusion may result in hypotension. Protamine should be given IV over 10 minutes. If the LMW heparin dose has been given within 3-4 hours give 1 mg protamine/1 mg of enoxaparin dose. If initiating treatment more than 4 hours after last dose given, give 0.5 mg protamine/1 mg of enoxaparin.Ī second dose of 0.5 mg protamine /1mg of enoxaparin dose may be given if the PTT remains prolonged 2-4 hours after the initial dose. If immediate reversal is required protamine sulfate will result in partial neutralization. Termination of the SQ injection generally will terminate the anticoagulant effect.

Enoxaparin antidote