![]() They have their own Xa inhibitor coming along (bextrixaban), but if this protein makes it through, they'll have done the whole field a favor as well as themselves. ![]() Portola Therapeutics has developed a Factor Xa mimic that binds the inhibitors, and thus titrates their effects. We don't often have to consider this issue, but it's a big one in this case. In the case of minor GI bleeding (e.g., self-limited scanty haematochezia not causing anaemia), there is no need for urgent anticoagulation reversal vitamin K, given orally (15 mg) or IV at low-dosage (12.5 mg) may be considered if INR values are 5. Anticoagulants need a corresponding way to cancel out their effects, in case of overdose or other trouble. Blood clotting therapies have a narrow window to work in - anything effective enough to be beneficial will be effective enough to be trouble under other circumstances. The Factor Xa inhibitors are a recent entry into this area, with Bayer's Xarelto ( rivaroxaban) as the key example so far.īut there's a problem with any Xa inhibitor: there's no antidote for them. The anticoagulant field is a huge one, with Plavix, warfarin, and plenty of others jostling for a share of a huge market (both for patients to take themselves, and for hospital use). Beginning with the introduction of the antiplatelet agent clopidogrel in 2002, several more potent oral antiplatelet and oral anticoagulant agents have been approved for use. Here's a drug-discovery problem that you don't often have to think about. For decades, aspirin and warfarin have been the predominant antiplatelet and anticoagulant alternatives.
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