Start practicing

Medical Emergencies · single question

A patient on rivaroxaban (a direct factor Xa inhibitor) develops major bleeding. Which reversal agent is FDA-approved specifically for this drug class?

  1. Andexanet alfa (Andexxa), the FDA-approved specific reversal agent for rivaroxaban and apixaban
  2. Vitamin K (this is specific to warfarin/vitamin K antagonist reversal, NOT factor Xa inhibitors)
  3. Idarucizumab (this is specific to dabigatran, a direct thrombin inhibitor, not a factor Xa inhibitor)
  4. Protamine sulfate
Show answer and explanation

Correct answer: A. Andexanet alfa (Andexxa), the FDA-approved specific reversal agent for rivaroxaban and apixaban

Andexanet alfa, FDA-approved in 2018, is the specific reversal agent for the direct factor Xa inhibitors rivaroxaban and apixaban. Vitamin K only reverses warfarin (a vitamin K antagonist) and has no role in reversing direct factor Xa inhibitors. Idarucizumab is the specific reversal agent for dabigatran (a direct thrombin inhibitor), and protamine sulfate reverses heparin.

Practice Medical Emergencies questions Medical Emergencies study notes

More Medical Emergencies practice questions