Direct Factor Xa inhibitors

Rivaroxaban

directly inhibit the conversion of prothrombin to thrombin without using antithrombinIII as an intermediary

• Postsurgical VTE prophylaxis ·        
• As an alternative to heparins in patients with severe HIT

• Initial: 15-20 mg po daily for 3 weeks –
• on exam (20 mg)

• active bleeding
• Pregnancy
• pts at increased risk of bleeding

bleeding

• Metabolism is via CYP450 3A4 enzymes
• It is a substate of P-glycoprotein (Pgp)
• There are no monitoring requirements