Michael Spencer

Rivaroxaban is one of 4 Factor Xe inhibiter anticoagulants currently available. Potentially fatal bleeding can take place following overdose of these drugs or following even relatively injury when patients are taking them. A drug specifically designed to reverse the anti-coagulant effect of the Factor Xa antagonist, Andexanet alfa, is available in some countries which can be used in such circumstances to reverse the anticoagulant effect of these drugs. Evidence was given at the inquest to the effect It is not yet available in the UK, even for compassionate use, and that its availability could be lifesaving when severe bleeding occurs during treatment with Factor Xa inhibitor anti-coagulant drugs. For the avoidance of doubt, this evidence was given in the course of a general explanation of the action of Rivaroxaban and the management of pathological bleeding during its use. It was made clear that the ready availability of Andexanet alfa would not have changed the outcome in Mr Spencer’s case. The concern expressed was in relation to the current non-availability of this specific reversal agent in the face of the increasing clinical use of Factor Xa inhibitor anticoagulants.