Home Drug Guide Betrixaban

Drug Guide

Generic Name

Betrixaban

Brand Names Bevyxxa

Classification

Therapeutic: Anticoagulant, Direct Factor Xa Inhibitor

Pharmacological: Oral anticoagulant, Factor Xa inhibitor

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

Assessment: Monitor for signs of bleeding, renal function, signs of thrombotic events

Diagnoses:

  • Risk for bleeding

Implementation: Administer with food; assess for bleeding regularly; adjust dose based on renal function

Evaluation: Effectiveness evidenced by absence of thromboembolic events; adverse effects management

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

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.