Direct factor Xa inhibitors

[2] Other side effects may include stomach upset, dizziness, anemia or increased blood levels of liver enzymes.

[2] Andexanet alfa, a specific antidote to reverse the anticoagulant activity of direct Xa inhibitors in the event of major bleeding, was approved by the FDA in 2018.

[12][13] Also in contrast to warfarin and phenprocoumon, direct factor Xa inhibitors do not require frequent monitoring of the prothrombin time (also called the INR) and dose adjustments.

[12] Prior to the introduction of direct factor Xa inhibitors, vitamin K antagonists such as warfarin were the only oral anticoagulants for over 60 years, and together with heparin have been the main blood thinners in use.

[6] The monitoring of warfarin and keeping the international normalized ratio (INR) between 2.0 and 3.0, along with avoiding over and under treatment, has driven a search for an alternative.

[21] Xabans that never reached the market include darexaban (YM150) from Astellas,[22][23] otamixaban from Sanofi,[24] letaxaban (TAK-442) from Takeda,[25] and eribaxaban (PD0348292) from Pfizer.

Coagulation in vivo, shows final common pathway and where factor Xa acts
Antistasin , the first discovered naturally occurring direct Xa inhibitor
Rivaroxaban , the first synthetic direct Xa inhibitor marketed as a drug