Critical Clarification: Question Appears to Contain a Medication Name Error
The medication "Adipexa" mentioned in your question does not match any known anticoagulant reversal agent. Based on the context of your expanded question referencing "Andexxa (andexanet alfa)" and the blood pressure reading, I will address whether Andexanet alfa can be administered as ongoing therapy to a 35-year-old woman with BP 150/93 mmHg.
Direct Answer: Andexanet Alfa is NOT an Ongoing Therapy
Andexanet alfa is exclusively indicated for acute, single-dose reversal of life-threatening or uncontrolled bleeding associated with factor Xa inhibitors (apixaban, rivaroxaban, edoxaban)—it is never given as continued or ongoing therapy. 1, 2
Why Andexanet Alfa Cannot Be Continued Therapy
Andexanet alfa is administered as a one-time bolus followed by a 2-hour infusion only, with dosing consisting of either a low-dose regimen (400 mg bolus over 15 minutes + 480 mg infusion over 2 hours) or high-dose regimen (800 mg bolus over 30 minutes + 960 mg infusion over 2 hours). 1, 2
The reversal effect is transient, with anti-factor Xa activity returning toward baseline approximately 2-4 hours after the infusion ends, making repeated dosing both impractical and not evidence-based. 3, 1, 2
The drug is FDA-approved only for emergency reversal of anticoagulation in patients with life-threatening bleeding (intracranial, gastrointestinal, retroperitoneal hemorrhage) or requiring urgent high-bleeding-risk surgery. 1, 4
Blood Pressure Considerations (If This Were Relevant)
The BP of 150/93 mmHg represents Stage 1 hypertension in a 35-year-old woman, which would require evaluation and management per standard hypertension guidelines, but this is completely unrelated to andexanet alfa administration. 3
Andexanet alfa administration decisions are based on bleeding severity and anticoagulant exposure, not on blood pressure values, unless the patient has hypertensive emergency with intracranial hemorrhage. 1, 2
Critical Safety Concern: Thrombotic Risk
Thrombotic events occur in 10-18% of patients within 30 days after andexanet alfa administration, with the majority occurring in patients who did not promptly resume anticoagulation after bleeding control. 1, 2, 5
Prompt resumption of anticoagulation therapy is essential once hemostasis is achieved to mitigate this substantial thrombotic risk. 1, 2
Common Pitfall to Avoid
Do not confuse andexanet alfa with chronic anticoagulants (apixaban, rivaroxaban, edoxaban, warfarin) that are given as ongoing therapy. Andexanet alfa is the reversal agent for factor Xa inhibitors, not a therapeutic anticoagulant itself. 1, 4
If you intended to ask about continuing apixaban (Eliquis) or another factor Xa inhibitor in a patient with BP 150/93 mmHg, please clarify, as that would be an entirely different clinical question requiring assessment of stroke risk (CHA₂DS₂-VASc score), bleeding risk (HAS-BLED score), and blood pressure control. 3