Drug interactions
Andexanet alfa + Heparin
Severity: Major
Andexanet alfa and Heparin: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
After andexanet alfa, unfractionated heparin may be unresponsive, with activated clotting times not prolonging as expected. This can lead to inadequate anticoagulation, for example during procedures.
What this interaction means in plain words
Andexanet alfa and Heparin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Andexanet alfa belongs to Cardiovascular; Heparin belongs to Cardiovascular.
Why it happens
Andexanet alfa binds heparin-antithrombin complexes, neutralizing heparin's anticoagulant effect.
What to do
Do not use unfractionated heparin after andexanet alfa; select an alternative anticoagulant if one is needed.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Heparin
- Defibrotide + Heparin Contraindicated
- Heparin + Ketorolac Contraindicated
- Heparin + Oritavancin Contraindicated
- Acemetacin + Heparin Major
- Acetylsalicylic acid + Heparin Major
- Alteplase + Heparin Major
Frequently asked questions
Can I take Andexanet alfa with Heparin?
MediHelp rates the interaction as major. Andexanet alfa and Heparin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. After andexanet alfa, unfractionated heparin may be unresponsive, with activated clotting times not prolonging as expected. This can lead to inadequate anticoagulation, for example during procedures.
How serious is the interaction between Andexanet alfa and Heparin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use unfractionated heparin after andexanet alfa; select an alternative anticoagulant if one is needed.
What other medicines interact with Heparin?
MediHelp also lists interactions of Heparin with, for example, Defibrotide, Ketorolac, Oritavancin. The full list is on the Heparin page.
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