Betrixaban
BEVYXXA
Pronunciation: be-TRIX-a-ban
What it isAn oral direct factor Xa inhibitor (DOAC) with a long half-life and minimal CYP metabolism, largely eliminated unchanged and dependent on P-glycoprotein.
Why this oneIt was approved uniquely for extended VTE prophylaxis in acutely ill hospitalized medical patients, a longer-duration indication other DOACs lacked (now discontinued in the US).
What limits itIt carries a boxed warning for spinal/epidural hematoma with neuraxial procedures, interacts via P-gp, and requires dose reduction or avoidance in renal impairment.
⚠ BOXED WARNING
- spinal/epidural hematoma
Principal riskEpidural or spinal hematoma, which can cause long-term or permanent paralysis, may occur in patients receiving neuraxial anesthesia or undergoing spinal puncture.