Grundlagen zur Anwendung von Andexanet

Research output: Contribution to journalResearch articleContributedpeer-review


  • J Koscielny - , Charité – Universitätsmedizin Berlin (Author)
  • I Birschmann - , Herz- und Diabeteszentrum Nordrhein-Westfalen (Author)
  • R Bauersachs - , Cardioangiologisches Centrum Bethanien (Author)
  • D Trenk - , University Medical Center Freiburg (Author)
  • F Langer - , University Hospital Hamburg Eppendorf (Author)
  • P Möhnle - , Hospital of the Ludwig-Maximilians-University (LMU) Munich (Author)
  • J Beyer-Westendorf - , Department of internal Medicine I, University Hospital Carl Gustav Carus Dresden (Author)


BACKGROUND:  For life-threatening or uncontrollable bleeding in association with the thrombin inhibitor dabigatran, the monoclonal antibody fragment idarucizumab is available, and for bleeding in association with the direct factor Xa inhibitors rivaroxaban or apixaban, the modified recombinant FXa protein andexanet is available for reversal. These antidotes represent emergency drugs that are typically used only after performing guideline-compliant multimodal measures.

METHODS:  An interdisciplinary group of experienced experts in the fields of angiology, hematology, internal medicine, clinical pharmacology, laboratory medicine, transfusion medicine, anesthesiology, intensive care, and hemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence.

RESULTS:  Reversal of oral anticoagulants should be considered for severe bleeding in the following situations: (1) life-threatening bleeding or refractory hemorrhagic shock, (2) intracerebral bleeding, or (3) endoscopically unstoppable gastrointestinal bleeding. After successful hemostasis, anticoagulation (e.g., direct oral anticoagulant, vitamin K antagonist, and heparin) should be resumed promptly, taking into account individual bleeding and thromboembolic risk.

DISCUSSION:  This article aims to facilitate the management of patients with andexanet by all medical disciplines involved, thereby ensuring optimal care of patients during bleeding episodes.

Translated title of the contribution
Basics for the Use of Andexanet


Original languageGerman
Pages (from-to)398-409
Number of pages12
Issue number6
Publication statusPublished - Dec 2023

External IDs

Scopus 85174300205



  • Humans, Anticoagulants/therapeutic use, Hemorrhage/chemically induced, Rivaroxaban/therapeutic use, Heparin/therapeutic use, Recombinant Proteins/therapeutic use, Factor Xa Inhibitors/therapeutic use, Administration, Oral