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Clinical data | |
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Trade names | Bevyxxa |
Other names | PRT054021, PRT064445 |
AHFS/Drugs.com | bevyxxa |
Routes of administration | By mouth |
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Pharmacokinetic data | |
Protein binding | 60% |
Elimination half-life | 19–27 hrs |
Duration of action | ≥72 hrs |
Excretion | 85% feces, 11% urine |
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ECHA InfoCard | 100.207.746 ![]() |
Chemical and physical data | |
Formula | C23H22ClN5O3 |
Molar mass | 451.91 g·mol−1 |
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Betrixaban (trade name Bevyxxa) is an oral anticoagulant drug which acts as a direct factor Xa inhibitor.[1] Betrixaban is FDA approved for venous thrombosis prevention in adults hospitalized for an acute illness who are at risk for thromboembolic complications.[2] Compared to other directly acting oral anticoagulants betrixaban has relatively low renal excretion and is not metabolized by CYP3A4.[3]
Betrixaban was originally developed by Millennium Pharmaceuticals. Portola Pharmaceuticals acquired rights for betrixaban in 2004 and co-developed it with Merck. In 2011 Merck discontinued joint development.[4]
The drug has undergone clinical trials for prevention of embolism after knee surgery[5] and for prevention of stroke following non-valvular atrial fibrillation.[6][7] Betrixaban was also studied in a large phase III clinical trial for extended duration thromboprophylaxis in acute ill patients.[8] Previously apixaban and rivaroxaban have failed to show positive risk/benefit ratio in this indication compared to enoxaparin.[9][10][non-primary source needed] APEX trial compared betrixaban with enoxaparin and included 7513 patients. Lower rate of VTE events was found in betrixaban arm with no increase in major bleedings compared to enoxaparin.[11] Based on these results betrixaban was approved by FDA on June 23, 2017, becoming the first DOAC approved for extended prophylaxis in hospitalized patients.[12]
Betrixaban has been also reviewed by EMA but didn't receive marketing approval in EU mainly due to concerns of increased bleeding risk and absence of reversal agent.[13]
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Antiplatelet drugs |
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Thrombolytic drugs/ fibrinolytics |
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