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Oral Factor Xa Inhibitor (DOAC — Extended Duration)

Betrixaban (Extended VTE Prophylaxis — Medical Patients)

Brand names: Bevyxxa (US — not MHRA licensed)

Betrixaban is an oral direct factor Xa inhibitor anticoagulant developed for extended venous thromboembolism prophylaxis in acutely ill hospitalised medical patients.

Dosing — no UK product information found

We found no UK product information (SmPC) for this medicine or presentation on the eMC or MHRA Products (checked October 2026). It may be unlicensed in the UK, imported, a medical device, or no longer marketed. ClinCalc Pro shows only doses it can trace to official product information, so none is shown — follow your specialist service or local guideline.

Clinical monograph

How it works

It selectively and reversibly inhibits factor Xa, reducing thrombin generation and fibrin clot formation within the coagulation cascade.

Prescribing in practice

  • As with all anticoagulants, bleeding is the principal risk and it should be avoided where there is active clinically significant bleeding.
  • Use is affected by renal impairment and by concurrent P-glycoprotein inhibitors, which can increase exposure.
  • It is not widely used in UK practice; consult current prescribing references for availability and place in therapy.

Monitoring

Monitor renal function and for signs of bleeding, as routine coagulation monitoring is not generally required.

Counselling the patient

  • This is a blood-thinning medicine used to help prevent clots after an acute medical illness.
  • Report any unusual bleeding, bruising or blood in the urine or stool.
  • Tell healthcare staff you take an anticoagulant before any procedure.

Evidence & guidelines

The APEX trial evaluated extended betrixaban prophylaxis against enoxaparin in acutely ill medical patients at risk of venous thromboembolism.

Reference: APEX Trial (Cohen et al. NEJM 2016); FDA Bevyxxa Prescribing Information 2017; ESC VTE Prevention in Medical Patients 2023; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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