Which medications in the drug class Direct Thrombin Inhibitors and Factor Xa Inhibitors are used in the treatment of Pulmonary Embolism (PE)?

Updated: Sep 18, 2020
  • Author: Daniel R Ouellette, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Direct Thrombin Inhibitors and Factor Xa Inhibitors

Factor Xa inhibitors inhibit platelet activation by selectively blocking the active site of factor Xa without requiring a cofactor (eg, antithrombin III) for activity. Direct thrombin inhibitors prevents thrombus development through direct, competitive inhibition of thrombin, thus blocking the conversion of fibrinogen to fibrin during the coagulation cascade.

Rivaroxaban (Xarelto)

Rivaroxaban is indicated for treatment of PE and for prevention of recurrence (following initial 6 months of treatment). Additionally, it is indicated for a variety of treatment and prophylaxis VTE indications, including the following:

--Risk reduction of stroke and systemic embolism in nonvalvular atrial fibrillation

--Treatment of DVT

--Reduction in risk of recurrent DVT and/or PE

--Prophylaxis of DVT following hip or knee replacement surgery

--Prophylaxis of VTE in acutely ill medical patients at risk for thromboembolic complications owing to restricted mobility (and who are not at high risk of bleeding)

--Risk reduction of major cardiovascular events with coronary artery disease or peripheral artery disease

Apixaban (Eliquis)

Indicated for treatment of PE and for prevention of recurrence (following initial 6 months of treatment).

Dabigatran (Pradaxa)

Dabigatran is indicated for treatment of DVT and PE in patients who have been treated with a parenteral anticoagulant for 5-10 days. It is also indicated to reduce the risk of recurrence of DVT and PE in patients who have been previously treated.

Edoxaban (Savaysa)

Edoxaban is a factor Xa inhibitor indicated for treatment of DVT and PE in patients who have been initially treated with a parenteral anticoagulant for 5-10 days.

Betrixaban (Bevyxxa)

Betrixaban is indicated for prophylaxis of venous thromboembolism (VTE) in adults hospitalized for acute medical illness who are at risk for thromboembolic complications owing to moderate or severe restricted mobility and other risk factors that may cause VTE.


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