Summary

• avoid the use of andexanet alfa before heparinization (e.g. during surgery);
• andexanet alfa causes unresponsiveness to the anticoagulant effects of heparin;
• results of coagulation tests might be misleading when andexanet alfa and heparin are given within a short time of one another. Monitoring of andexanet alfa’s effect has not been validated while heparin is active;
• use of andexanet alfa for FXa reversal before urgent surgery has not been evaluated.