Factor Xa (fXa) inhibitors have become a mainstream therapeutic option for patients needing anticoagulation. Due to their convenience of use in comparison to vitamin K inhibitors, many patients and health care providers are choosing non-vitamin K oral anticoagulants (NOACs) over warfarin. Despite the benefits these drugs present in average daily life, one cannot ignore the biggest tradeoff for such convenience – the lack of immediate reversibility in situations of significant bleeding. Unlike other anticoagulants such as heparin and warfarin, there is no antidote for the DOACs. However, recent clinical trials have been published that may finally provide an answer to this problem. Andexanet alfa, a novel factor Xa analog, has been shown to decrease factor Xa activity within a matter of minutes after administration. In this review, we present the current literature on this novel drug, with an emphasis on data from the various trials that have been completed.

Keywords: Anticoagulants, Bleeding Time, Factor Xa