NON-FORMULARY, stocked agent with specific criteria for use:

• Andexxa is orderable only by attending physicians from Neurocritical Care and Vascular/Neurosurgery and for adult inpatients who meet the following criteria for use:
  • Apixaban- or rivaroxaban-related acute life-threatening, active intracranial hemorrhage (ICH)
        AND
  • Must have received apixaban or rivaroxaban within the last 18 hours
        AND
  • Glasgow coma score equal to or greater than 7 at baseline upon admission or prior to clinical deterioration   
        AND
  • Estimated ICH volume equal to or less than 60 mL
        AND
  • ICH score equal to or less than 3 (for those patients with primary ICH)
        AND
  • Does NOT have severe sepsis or septic shock
        AND
  • Has NOT received prothrombin complex concentrate products (e.g., Kcentra) or recombinant factor VIIa (i.e., NovoSeven) or factor eight inhibitor bypassing activity (i.e., FEIBA) or FFP within 48 hours
        AND
  • Has NOT had a major thrombotic event within the past 2 weeks (including myocardial infarction, disseminated intravascular coagulation, cerebral vascular accident, transient ischemic attack, or unstable angina pectoris hospitalization)
        AND
  • Anti-Xa (enoxaparin assay) is equal to or greater than 0.4 IU/mL

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