Sun14November1246PM 37

Are the following true or false of rivaroxaban?

True / False

Is licensed for prophylaxis and treatment of deep venous thrombosis Incorrect answer selected

The dose can be titrated using the prothrombin time Correct

Is a direct thrombin inhibitor Incorrect answer selected

May be reversed with protamine Correct

Must be given subcutaneously or intravenously Correct

Explanation

Rivaroxaban is an orally active factor Xa inhibitor (rivaroxaban) which is licensed in the UK for prevention and treatment of venous thromboembolism, anticoagulation of non-valvular atrial fibrillation and long term oral anticoagulation for recurrent pulmonary emboli. It is reliably bioavailable orally and is presented as a tablet.

Commonly used assays of coagulation function may demonstrate non-specific abnormalities which do not correlate with function or plasma level. More advanced tests may be used but are not commonly available, and monitoring is not commonly used in clinical practice.

Protamine has no effect on the activity or plasma concentration of rivaroxaban. Andexanet alfa is a modified recombinant proteinderived from human coagulation factor X and can be used to reverse the effects of rivaroxaban.

Although the prothrombin time is altered, the alteration bears no reliable relation to activity or plasma concentration and cannot be used to titrate to effect.

Reference:

NICE. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults (TA170).

NICE. Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation (TA256).

NICE. Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism (TA261).

NICE. Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism (TA287).

Answer Statistics

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Average score: 88.03%

Times answered: 239