Generic Name

Betrixaban

---

Classification

FDA Approved Indications

• Prevention of venous thromboembolism (VTE) in hospitalized patients at risk for thromboembolic complications due to medically ill hospitalized patients

Mechanism of Action

Betrixaban selectively inhibits activity of Factor Xa, reducing thrombin generation and thrombus development.

Dosage and Administration

Adult: 160 mg on day 1, followed by 80 mg once daily with food for 35-42 days

Pediatric: Not approved for pediatric use

Geriatric: Use with caution; dose adjustments not specifically required but renal function should be monitored

Renal Impairment: Adjust dose based on renal function; contraindicated if CrCl <15 mL/min

Hepatic Impairment: Use with caution; contraindicated in severe hepatic impairment

Pharmacokinetics

Absorption: Bioavailability approximately 34%

Distribution: Vd approximately 54 L, protein binding about 55%

Metabolism: Minimal hepatic metabolism; primarily excreted unchanged

Excretion: Predominantly fecal (via biliary excretion); some renal excretion

Half Life: approximately 19-27 hours

Contraindications

• Active pathological bleeding, severe hypersensitivity

Precautions

• Renal impairment, hepatic impairment, elderly patients, patients with increased risk of bleeding

Adverse Reactions - Common

• bleeding, including gastrointestinal bleeding (Common)
• bradyarrhythmia (Uncommon)

Adverse Reactions - Serious

• significant bleeding leading to death or disability (Serious, rare)
• hepatotoxicity (Rare)

Drug-Drug Interactions

• Other anticoagulants, antiplatelet agents, certain NSAIDs
• Rifampin (may reduce efficacy)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report unusual bleeding or bruising
• Take medication as prescribed, with food
• Inform healthcare provider of all medications

Special Considerations

Black Box Warnings:

• Risk of bleeding

Genetic Factors: None established

Lab Test Interference: May slightly increase PT/INR but not recommended for monitoring anticoagulation

Overdose Management

Signs/Symptoms: Excessive bleeding, hematomas, gastrointestinal hemorrhage

Treatment: Discontinue medication, apply local hemostasis, provide supportive care, consider administration of activated charcoal if ingestion is recent, and consider reversal agents if available and appropriate.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F)

Stability: Stable up to the expiration date on the package