Direct factor Xa inhibitor in the prevention of thromboembolism

Venous thromboembolism is the third most common cause of vascular death after myocardial infarction and stroke, and is associated with considerable morbidity and premature mortality. The incidence of the most serious consequence of venous thromboembolism, fatal pulmonary embolism, ranges from 0.01% to 5% among hospitalised medical patients with multiple risk factors, and is currently considered the commonest avoidable cause of hospital death. Rivaroxaban is a small-molecule factor Xa inhibitor that belongs to a new class of direct oral anticoagulant agents that directly inhibit single enzymes in the coagulation pathway. Rivaroxaban has many advantages over vitamin K antagonists and unfractionated heparin and may become an alternative to traditional anticoagulant agents in patients at risk for thromboembolism. Moreover, antidotes exist and are in the progress of development, both specific and non-specific, for the treatment of overdose or side effects, including bleeding.