Direct Factor Xa Inhibitor

6 Drugs classified under this drug class

Anticoagulant, Direct Factor Xa Inhibitor. Apixaban 2.5 mg, Apixaban 5 mg.
FC tabs 2.5mg/5 mg X30
Prevent. of VTE (VTEp): elect. hip or knee replacem. surgery 2.5 mg taken orally 2Xd, initial dose to be taken 12 to 24 hs after surg. In ptts. undergoing hip replacem., tmt. is 32 to 38 days. In ptts. undergoing knee replacem., tmt. is 10 to 14 days. Prevent. of stroke and syst. embol. in ptts. with non-valv. atrial fibrill. (NVAF): 5 mg taken orally 2Xd. See full prescript. info.
 for 2.5 mg: prevent. of venous thromboemb. events (VTE) in adlt. ptts. who have undergone elect. hip or knee replacem.
 for both 2.5 and 5 mg: prevent. of stroke and syst. embol. in adlt. ptts. with non-valv. atrial fibrill. (NVAF), with one or more risk factors, such as prior stroke or transient isch. attack (TIA); age≥ 75 y; HT; diabetes mellitus; sympt. heart fail. (NYHA Class ≥ II). Tmt. of deep vein thromb.(DVT) and pulmon. embol. (PE), and prevent. of recurrent DVT and PE in adults.
C/I: Hypersens. Act. clin. signif. bleeding. • Hep. dis. assoc. with coagulopathy and clinic. relevant bleeding risk • Lesion or condit. posing a signif. risk factor for major bleeding, incl. current or recent GI ulcerat., presence of malign. neoplasms at high risk of bleeding, recent brain or spinal injury, recent brain, spinal or ophthalmic surg., recent intracran. haemorrhage, known or susp. oesophageal varices, arteriovenous malform., vasc. aneurysms or major intraspinal or intracerebral vasc. abnorm. • Concom. tmt. with any other anticoag. agent e.g. unfraction. heparin (UFH), low MW heparins (enoxaparin, dalteparin, etc.), heparin deriv. (fondaparinux, etc.), oral anticoag. (warfarin, rivaroxaban, dabigatran, etc.) except under spec. circumst. of switching anticoag. ther. or when UFH is given at doses necess. to maintain an open ctral. venous or arterial catheter.

Anticoagulant, Direct Factor Xa Inhibitor. Apixaban 2.5 mg, 5 mg.
Preven. of VTE (VTEp): elective hip or
knee replac. surg.- 2.5 mg ×2/d.
Init. dose should be taken 12 - 24 hrs.
after surg.
In pts. underg. hip replac. surg.- The
recom. duration of tmt. is 32- 38 d.
In pts. underg. knee replac. surg.: The
recom. duration of tmt. is 10- 14 d.
Preven. of stroke & syst. embol. in pts.
with non-valvul. atrial fibril. (NVAF):
5 mg ×2/d.
Dose reduction: 2.5mg×2/d in pts. with
NVAF and at least two of the follow.
characteristics: age ≥ 80 yrs., bdy. wt. ≤
60 kg, or ser. Cr ≥ 1.5 mg/dL (133
micromole/L).
Ther. should be cont. long term.
Tmt. of DVT, tmt. of PE and preven. of
recur. DVT &PE (VTEt)
Tmt. of acute DVT and tmt. of PE is 10
mg×2/d for the first 7 d. follow. by 5
mg ×2/d.
As per avail. med. guidelines, short
durat. of tmt. (at least 3 mnths.) should
be based on transient risk factor. (e.g.
recent surg., trauma, immobilis.).
Preven. of recur. DVT & PE is 2.5
mg×2/d. When preven. of recur. DVT &
PE is indic., the 2.5 mg×2/d should be
init. follow. complet. of 6 mnths. of tmt.
5 mg×2/d or with another anticoag.
See Lit.
2.5 mg tabs. - Preven. of VTE in adult pts.
who have undergone elect. hip or knee
replac. surg.
Preven. of stroke and syst. embol. in adult
pts. NVAF, with one/ more risk fact., e.g as
prior stroke, TIA; age ≥ 75 yrs.; hypertens.;
diabetes. mell.; symptom. HF (NYHA Class
≥ II).
Tmt. of DVT, PE , and preven. of recur.
DVT & PE in adult.
5 mg tabs. - Preven. of stroke, syst. embol.
in adult pts. NVAF, with one/ more risk
fact., e.g. prior stroke or TIA; age ≥ 75 yrs.;
hypertens.; diabetes mell.; symptom. HF
(NYHA Class ≥ II).
Tmt. of DVT, PE in adult. 
C/I: Hypersens.
Active clinic. signific. bleed.
Hep. dis. assoc. with coagulopathy
&clinic. relevant bleed. risk.
Lesion/ condit. if consid. a signific. risk
factor for major bleed. This may include
current or recent GI ulcer., presence of
malig. neoplasm. at high risk of bleed.,
recent brain, spinal inj., recent brain,
spinal or ophthalmic surg., recent
intracran. haemorrhage, known/
suspect. esophagi. varices, arterioven.
malform., vasc. aneurysms or major
intraspinal or intracerebr. vascular
abnorm.
Concom. tmt. with any other anticoag.
agent e.g. unfraction. heparin (UHF), low
molec. wt. heparins (enoxaparin,
dalteparin, etc.), heparin derivat.
(fondaparinux, etc.), oral anticoag.
(warfarin, rivaroxaban, dabigatran, etc.)
except under specific circumstances of
switching anticoag. ther.or when UHF is
given at doses necessary to maintain an
open centr. ven. or arterial catheter or when UFH is given during catheter ablation for atrial fibrillation

Antithrombotic Agent, Direct Factor Xa Inhibitor. Edoxaban 15 mg , 30 mg , 60 mg.
FC tab.: 10/28/30X15/30/60 mg.edoxaban
Prevent. of stroke and syst. embol. in adlt pts with nonvalv. atrial fibrill (NVAF) with risk factors, such as congest. HF, HyperT, age ≥ 75 years, diab. mell., prior stroke or trans. isch. attack (TIA).
Tmt of deep vein thromb. (DVT) and pulm. embol. (PE), and
prevent. of recurr. DVT and PE in adults
C/I: Hypersens.
Clinic. sign. act. bleeding.
Hepatic dis. assoc. with coagulopathy and clin. relev. bleeding risk.
Lesion or condit., with a sign. risk for major bleed. such as curr. or recent GI ulcerat., malign. neopl. at high risk of bleed., recent brain or spinal inj., recent brain, spinal or ophth. surg., recent intracranial haemorrh., known or susp. oesophageal varices, arteriovenous malform., vasc. aneurysms or major intraspinal or intracerebr. vasc. abnorm.
Uncontroll. sev. hypert.
Concom. tmt with other anticoag. e.g. UFH, LMWH (enoxaparin, dalteparin, etc.), heparin deriv. (fondaparinux, etc.), oral anticoag. (warfarin, dabigatran etexilate, rivaroxaban, apixaban etc.) except under spec. circumst. of switching oral anticoag. ther. or when UFH is given at doses to maintain an open ctral ven. or arter. catheter.
Pregn. and breast-feed.

Pregn. and breast-feed.

Direct Factor Xa Inhibitor. Rivaroxaban 2.5 mg, 10 mg, 15 mg, 20 mg.
FC Tab: 56x 2.5mg, 30 X 10 mg, 28 X 15 mg, 28 X 20 mg
Dosage to be adj. indiv. according to the pt’s. med. condit. See lit.
Rivaroxaban Dexcel 2.5 mg:
Co-admin. with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel, for t prevent. of atherothrombotic events in adult pts. after an acute coron. syndr. (ACS) with elev. cardiac biomarkers.
Co-admin. with acetylsalicylic acid (ASA), for the prevent. of atherothrombotic events in adult pts. with coron. artery dis. (CAD) or symptom. periph. artery dis. (PAD) at high risk of isch. events.
Rivaroxaban Dexcel 10 mg:
Prevent. of venous thromboembolism (VTE) in adult pts. undergoing elective hip or knee replacement surg.
Prevent. of recurrent deep vein thrombosis (DVT) and pulmon. embolism (PE), in adults (following complet. of at least 6 months ther. for DVT or PE).
Rivaroxaban Dexcel 15, 20 mg:
Prevent. of stroke and system. embolism in adult pts. with non-valv. atrial fibrill. with one or more risk factors, such as congestive HF, hypertension, age≥75, diabetes mell., prior stroke or transient isch. attack.
Tmt. of deep vein thrombosis (DVT) and pulmon. embolism (PE), and prevent. of recurr. DVT and PE in adults.
Paed. pop.: Tmt. of venous thromboembolism (VTE) and prevent. of VTE recurr. in children and adolesc. aged less than 18  and weighing from 30 kg to 50 kg after at least 5 days of init. parenteral anticoag. tmt..
C/I-Hypersens.
/Act. clinic. signif. bleeding.
/Lesion or condit., if considered to be a signif. risk for major bleeding. incl. current or recent GI ulcerat., presence of malign. neoplasms at high risk of bleeding, recent brain or spinal injury, recent brain, spinal or ophthalmic surg., recent intracranial haemorrhage, known or suspect. oesophageal varices, arteriovenous malformat., vasc. aneurysms or major intraspin. or intracerebr. vasc. abnormalities.
/ Concomit. tmt. with any other anticoag. e.g. unfraction. heparin (UFH), low MW heparins (enoxaparin, dalteparin, etc.), heparin derivat. (fondaparinux, etc.), oral anticoag. (warfarin, dabigatran etexilate, apixaban, etc.) except under spec. circumst. of switching anticoag. ther. or when UFH is given at doses necess. to maintain an open ctral. venous or arterial catheter.
/Hepatic dis. assoc. with coagulopathy and clinic. relevant bleeding risk incl. cirrhotic p with Child Pugh B and C.
/Pregn. and breastfeed.
For Rivaroxaban Dexcel 2.5mg:
/Concom. tmt. of ACS with antiplatelet ther. in pts. with a prior stroke or a transient isch. attack (TIA).
/Concom. tmt. of CAD/PAD with ASA in pts. with prev. haemorrhagic or lacunar stroke, or any stroke within a month. See lit.

Direct Factor Xa Inhibitor. Rivaroxaban 2.5 mg.
TABS.: 14, 56, 60, 168
The recomm. dose is 2.5 mg×2/d. Pts. should also take a daily dose of 75 - 100 mg ASA or a dly. dose of 75 - 100 mg ASA in addit. to either a dly. dose of 75 mg clopidogrel. Tmt. should be regularly evaluated in the individ. pt. weighing the risk for ischaem. events against the bleed. risks. Extens. of tmt. beyond 12 mnths. should be done on an individ.pt. Tmt. should be started as soon as possible after stabilisat. of the ACS event (includ. revascularisat. procedures); at the earliest 24 hrs. after admis.to hospital and at the time when parenteral anticoagul. ther. would normally be discont. If a dose is missed the pt. should cont. with the regular dose as recommend. at the next scheduled time. The dose
should not be doubled to make up for a missed dose.
Co-admin. with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel , is indic. for the prevent. atherothrombotic events in adult pts. after an acute coronary syndr. (ACS) with elevated card. biomarkers.
C/I: Hypersens. Active clinical. signific. bleed. Lesion or condit. , if consid. to be a signific. risk for major bleed. This may include current or recent GI ulcerat., presence of malignant neoplasm. at high
risk of bleed., recent brain or spinal injury, recent brain, spinal or ophthalmic surg., recent intracran. haemorrhage, known or suspected oesophageal varices, arterioven. malformat., vascular aneurysms or major intraspin. or intracereb. vascular abnormal. Concom. tmt. with any other anticoagulant.e.g. unfractionat. heparin, low MW hepar. (enoxaparin, dalteparin, etc.), heparin derivatives (fondaparinux,
etc.), oral anticoag. (warfarin, dabigatran etexilate, apixaban, etc.) except under specific circumstan. of switching anticoag. ther. or when UFH is given at doses necessary to maintain an open central venous or arterial catheter. Concom. tmt. of ACS with antiplatelet ther. in pts. with a prior stroke or a TIA. Hep. dis. assoc. with coagulopathy and clinical. relevant bleed.risk include. cirrhotic pts. with Child Pugh B and C.
Pregnancy and breast feeding