Direct Factor Xa Inhibitors

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The page below is a sample from the LabCE course Antiplatelet and Anticoagulant Pharmacology for the Laboratory Professional. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Direct Factor Xa Inhibitors

  • Examples: This class of drugs includes rivaroxaban and apixaban. These drugs are administered orally.
  • Mechanism of action: These drugs bind to factor Xa, resulting in the direct inhibition of Xa. Once factor Xa is inhibited, it cannot function in the coagulation cascade and the fibrin clot cannot form.
  • Use: Direct Factor Xa Inhibitors are used in the chronic management of hypercoagulability.
  • Laboratory measurement: These drugs do not require routine laboratory monitoring.
  • Toxicity: All anticoagulants can cause excessive bleeding, but there is no reversal agent for this class of medications. However, Prothrombin Complex Concentrate (PCC) does provide a partial reversal of these drugs.
For more in-depth knowledge on how these medications affect coagulation testing: http://emj.bmj.com/content/emermed/early/2015/05/17/emermed-2015-204891.full.pdf