Factor Xa Inhibitors

Factor Xa Inhibitors directly inhibit factor Xa, which decreases conversion of prothrombin to thrombin and reduces clotting. Rivaroxaban and apixaban are used widely for the prevention of stroke in atrial fibrillation and treatment of DVT/PE.  Bleeding can be life-threatening and there is not a reliable reversal agent.  Less severe bleeding occurs with factor Xa inhibitors than with coumadin.

Class Drugs

• Rivaroxaban

• Apixaban

Class Mechanism of Action

Inhibits factor Xa

• Decreases conversion of prothrombin to thrombin

Site of action of Factor Xa inhibitors in the coagulation cascade.

Class Applications

Stroke prophylaxis in atrial fibrillation

Treatment of DVT/PE

Post-surgical prophylaxis of DVT/PE in hip/knee replacement surgery

Class Adverse Effects

Bleeding, can be life threatening

• No reversal agent

Fewer drug interactions than coumadin

Do not use in severe renal insufficiency

Avoid abrupt discontinuation

Drug Table

Drug Name	Application	Comments	Image
Rivaroxaban			"River" "Ox"
Apixaban			"A Pixie stick"