Dosing & Reconstitution
Review the Specific Dosing and Reconstitution Guidelines for Andexxa.
 
NOTE: For efficient and timely infusion, it is recommended that the IV bolus dose of Andexxa be prepared first and administered to the patient. The continuous IV infusion dose can then be prepared while the bolus dose is being administered to the patient, so that it is ready for administration immediately (within 2 minutes) following the bolus dose.
Dosing of Andexxa
 
Reconstitution of Andexxa*
 
IV Bolus Preparation
200 mg vials: Reconstitute the 200 mg vial of ANDEXXA with 20 mL of Sterile Water for Injection USP (SWFI).
  • Use a 20-mL (or larger) syringe and 20-gauge (or higher) needle.
  • Slowly inject the SWFI directing the solution onto the inside wall of the vial to minimize foaming.
  • To reduce the total reconstitution time needed during preparation, reconstitute all required vials in succession.
 
 
  • To ensure dissolution of the cake or powder, gently swirl each vial until complete dissolution of powder occurs (A). Do not shake (B); shaking could lead to foaming. Typical dissolution time for each vial is approximately 3 to 5 minutes. If dissolution is incomplete, discard the vial and do not use the product.
  • Upon reconstitution, the parenteral drug product should be inspected visually for particulate matter and discoloration prior to administration.
 
 
  • Use 60-mL or larger syringe with a 20-gauge (or higher) needle to withdraw the reconstituted ANDEXXA solution from each of the vials until the required dosing volume is achieved. Note the total volume withdrawn into the syringe.
  • Transfer the ANDEXXA solution from the syringe into an empty polyolefin or polyvinyl chloride IV bag with a volume of 250 mL or less.
  • Discard the syringe and needle.
  • Discard the vials, including any unused portion.
 
 
Continuous
IV Infusion
Preparation
Continuous IV Infusion Preparation
  • Follow the same procedure outlined above for IV bolus preparation. Reconstitute the total number of vials needed based on the dose requirements. More than one 40 to 60-mL syringe, or an equivalent 100-mL syringe, may be used for transfer of reconstituted solution to the IV bag.
  • Infusion will require a 0.2 or 0.22 micron in-line polyethersulfone or equivalent low protein-binding filter.
 
Administration of Andexxa
 
  • Upon reconstitution, the parenteral drug product should be inspected visually for particulate matter and discoloration prior to administration.
  • Administer ANDEXXA intravenously, using a 0.2 or 0.22 micron in-line polyethersulfone or equivalent low protein-binding filter.
  • Start the bolus at a target rate of approximately 30 mg/min.
  • Within two minutes following the bolus dose, administer the continuous IV infusion for up to 120 minutes.
 
Storage of Andexxa*
 
  • The reconstituted solution contains coagulation factor Xa (recombinant), inactivated-zhzo at a concentration of 10 mg/mL.
  • Reconstituted ANDEXXA in vials is stable at room temperature for up to eight hours, or may be stored for up to 24 hours at 2°C to 8°C
  • Reconstituted ANDEXXA in IV bags is stable at room temperature for up to eight hours.
 
Restarting Antithrombotic Therapy
 
  • Patients treated with FXa inhibitor therapy have underlying disease states that predispose them to thromboembolic events.
  • Reversing FXa inhibitor therapy exposes patients to the thrombotic risk of their underlying disease.
  • To reduce the risk of thrombosis, resume anticoagulant therapy as soon as medically appropriate following treatment with ANDEXXA.
 
 
*Note: Andexxa does not need to be brought to room temperature before reconstitution or administration to the patient.
Andexxa Dosing Calculator