What is an example of a Factor Xa (Xa) product?

From the Guidelines

Rivaroxaban is an example of a Factor Xa inhibitor product. Other Factor Xa inhibitors include apixaban (Eliquis), edoxaban (Savaysa/Lixiana), and betrixaban (Bevyxxa) 1. These medications work by selectively blocking the activity of Factor Xa, a key enzyme in the blood coagulation cascade, thereby preventing the formation of thrombin and subsequent clot formation.

Key Points

• Factor Xa inhibitors are commonly prescribed as anticoagulants to prevent stroke in patients with atrial fibrillation, treat deep vein thrombosis and pulmonary embolism, and prevent venous thromboembolism after hip or knee replacement surgery.
• Unlike traditional anticoagulants like warfarin, Factor Xa inhibitors typically don't require routine blood monitoring and have fewer food-drug interactions, making them more convenient for patients.
• However, they still carry bleeding risks and require appropriate dosing based on indication, renal function, age, and weight 1.

Mechanism of Action

The pharmacokinetic and pharmacodynamic profile of rivaroxaban is predictable and dose-dependent and is not influenced by age, gender, or body weight 1.

Clinical Use

Rivaroxaban has been investigated for the prevention and treatment of VTE, for stroke prevention in atrial fibrillation, and for prevention of recurrent ischemia in patients with ACS 1.

Important Considerations

Potent inhibitors of both CYP3A4 and P-glycoprotein, such as ketoconazole or ritonavir, are contraindicated because they increase plasma drug concentrations 1.

From the FDA Drug Label

Apixaban, a factor Xa (FXa) inhibitor, is chemically described as 1-(4- methoxyphenyl)-7-oxo-6-[4-(2-oxopiperidin-1-yl)phenyl]-4,5,6,7-tetrahydro-1H-pyrazolo[3,4 c]pyridine-3-carboxamide. Rivaroxaban, a factor Xa (FXa) inhibitor, is the active ingredient in XARELTO ® Tablets and XARELTO ® for oral suspension with the chemical name 5-Chloro-N-({(5S)-2-oxo-3-[4-(3-oxo-4-morpholinyl)phenyl]-1,3-oxazolidin-5-yl}methyl)-2-thiophenecarboxamide.

Examples of Factor Xa (Xa) products are:

• Apixaban 2
• Rivaroxaban 3

From the Research

Factor Xa (Xa) Products

• Factor Xa products are a class of anticoagulants that inhibit the activity of Factor Xa, a crucial enzyme in the coagulation cascade.
• An example of a Factor Xa product is Rivaroxaban, an oral anticoagulant that has been approved for several indications, including:
  • Reduction of risk of stroke and systemic embolism in nonvalvular atrial fibrillation 4, 5, 6
  • Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) 4, 5, 6
  • Prophylaxis of DVT following hip or knee replacement surgery 4, 5, 7
  • Prophylaxis of venous thromboembolism in acutely ill medical patients at risk for thromboembolic complications not at high risk of bleeding 4
  • Reduction of risk of major cardiovascular events in patients with chronic coronary artery disease or peripheral artery disease 4

Characteristics of Rivaroxaban

• Rivaroxaban is a direct oral Factor Xa inhibitor that has a predictable and reversible inhibition of Factor Xa activity 6, 8, 7
• It has a rapid onset of action and a consistent anticoagulation effect, precluding the need for routine monitoring of anticoagulation 7
• Rivaroxaban is administered orally, once or twice daily, depending on the indication 4, 5, 6
• It has a low potential for drug-drug or drug-food interactions 7