andexanet alfa + edoxaban

**Andexanet alfa + edoxaban** refers to the combination of the direct oral anticoagulant edoxaban (a direct factor Xa [FXa] inhibitor) with the FXa decoy protein andexanet alfa, which acts as a specific reversal agent for FXa inhibitor–induced anticoagulation. Edoxaban is an oral small molecule anticoagulant used for conditions such as nonvalvular atrial fibrillation and venous thromboembolism. Andexanet alfa is a genetically engineered recombinant modified human factor Xa protein, which lacks enzymatic activity but binds FXa inhibitors—including edoxaban—with high affinity, rapidly neutralizing their anticoagulant effect. This binding rapidly reverses the inhibition of endogenous FXa, restoring thrombin generation and hemostatic function. The combination is of clinical relevance in the context of major or life-threatening bleeding events in patients receiving edoxaban for anticoagulation, where andexanet alfa may be administered as an antidote to rapidly reverse the edoxaban effect[1][3][6][8].

Other names

coagulation factor Xa recombinant inactivated-zhzo + edoxaban