Resistance management of Rivaroxaban

Resistance problems with rivaroxaban are relatively uncommon. However, if patients develop resistance to rivaroxaban or need to adjust their treatment regimen, it is important for patients taking rivaroxaban to have regular blood tests to evaluate their coagulation function and anticoagulant effect. This can help identify any potential resistance problems early and doctors can consider switching to other types of anticoagulants, such as warfarin or apixaban.

Andexanet alfa is the antidote to rivaroxaban. Andexanet is a modified human Factor Xa decoy protein. It binds and chelates Factor Xa inhibitors with a half-life of approximately 1 hour. The FDA approved andexanet in May 2018 to reverse rivaroxaban's anticoagulant therapy in patients with life-threatening or uncontrolled bleeding. andexanet alfa should be used in such patients only after other hemostatic measures have failed (such as antifibrinolytic therapy [such as tranexamic acid or aminocaproic acid] and scavenging drugs with activated charcoal), or when the patient is at imminent risk of death from bleeding (in combination with other hemostatic measures), or in patients requiring emergency surgery.

RivaroxabanThe original drug is already on the market in China and can be found under Class B medical insurance. SpecificationsThe price of 10mg*5 tablets is around RMB 100. This drug may be sold in domestic pharmacies or hospitals. The Turkish version of rivaroxabanoriginal drug marketed overseas, specifications10mg*10 tablets, is priced around RMB 170 (the price may fluctuate due to exchange rates). The ingredients of the original rivaroxaban drug sold domestically and abroad are basically the same. Currently, there are no generic drugs produced in other countries on the market overseas.