Pharmacological agent | Reversal agent | Advantages | Disadvantages |
Apixaban | Andexanet | Rapid action (1–2 h). Reduction of VTE recurrence or death compared with placebo. | Contraindicated in case of severe hepatic insufficiency or CrCl<15 mL·min−1. Interacts with CYP3A4 and P-gp inducers and inhibitors. |
Dabigatran | Idarucizumab | Superior to warfarin for the prevention of recurrent VTE or VTE-related death. | Concomitant treatment with P-gp inhibitors, inducers and tacrolimus is contraindicated. Contraindicated if CrCl<30 mL·min−1. |
Edoxaban | Andexanet | Once-daily dosing can be used. Superior to warfarin for the prevention of stroke and major bleeding. | Contraindicated in severe hepatic impairment or CrCl<15 mL·min−1. Modified dosage when given concomitantly with P-gp inhibitors. |
Rivaroxaban | Andexanet | 70% reduction in recurrent VTE compared with aspirin | Contraindicated in case of moderate or severe hepatic impairment or CrCl<30 mL·min−1. Not recommended concomitantly with CYP3A4 and P-gp inhibitors. |
CrCl: creatinine clearance; P-gp: P-glycoprotein.