The oral factor Xa inhibitor rivaroxaban has shown a favorable wellbeing and efficacy profile as compared to the well known anticoagulant drug warfarin for the prevention and treatment of thromboembolic disorders. But treatment with this anticoagulant causes an increased bleeding risk. Bleeding complications can be managed by reversal agents to keep the patient hemodynamically stable until the effect of rivaroxaban weans off. This review highlighted the pharmacological characteristics of various reversal agents including Prothrombin complex concentrate, Activated Prothrombin complex concentrate, Recombinant factor VIIa, Andexanet alfa, and Ciraparantag used in the treatment of laboratory parameters prothrombin time (PT) and clotting time (CT) for the reversal of rivaroxaban. Specific antidotes are under development which will assist the clinical administration of severe bleeding events and emergency surgery or life-threatening bleeding. Reversal agents of apixaban have also been highlighted briefly in this manuscript.
Tanzeela Abdul Fattah, Aamer Saeed, Fayaz Ali Larik, and Pervaiz Ali Channar
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