The Generic Name for Betrixaban is Betrixaban
The generic name for the medication once sold under the brand name Bevyxxa is betrixaban. It is important to note that this oral anticoagulant was voluntarily discontinued by its manufacturer, Portola Pharmaceuticals, in April 2020. This withdrawal was a business decision and was not the result of any safety or quality issues with the product. While the medication is no longer available in the U.S., understanding its pharmacology, history, and comparison to other anticoagulants provides valuable context for patients and healthcare providers.
The Discontinuation of Bevyxxa (Betrixaban)
In April 2020, Portola Pharmaceuticals voluntarily withdrew Bevyxxa (betrixaban) from the market for business reasons. A notice was issued by the California State Board of Pharmacy in June 2020 regarding this market withdrawal. The manufacturer ceased all marketing and commercialization, although they did honor returns. This discontinuation was a business strategy decision and did not stem from safety or quality issues with the drug. Patients who were taking Bevyxxa were transitioned to alternative anticoagulant therapies by their healthcare providers.
Mechanism of Action: How Betrixaban Worked
Betrixaban is classified as an oral, direct Factor Xa inhibitor. It works by targeting Factor Xa, a crucial enzyme in the blood clotting process. By inhibiting Factor Xa, betrixaban prevents the conversion of prothrombin to thrombin, which is necessary for the formation of a fibrin clot. This mechanism is distinct from older anticoagulants like warfarin.
Former Medical Uses
Before its discontinuation, betrixaban was approved for a specific use: the extended-duration prophylaxis of venous thromboembolism (VTE). It was prescribed for adult patients who were hospitalized due to an acute medical illness, had reduced mobility, and other risk factors for developing blood clots. It was not approved for other common anticoagulant uses, such as preventing stroke in individuals with atrial fibrillation.
Comparison to Alternative Anticoagulants
With betrixaban no longer available, several alternative anticoagulant medications are used for VTE prophylaxis and other clotting conditions. Many of these are direct-acting oral anticoagulants (DOACs), similar in class to betrixaban, while older options like warfarin and heparin are also still utilized. Below is a comparison of betrixaban with some common alternatives:
| Feature | Betrixaban (Bevyxxa) | Apixaban (Eliquis) | Rivaroxaban (Xarelto) | Dabigatran (Pradaxa) |
|---|---|---|---|---|
| Drug Class | Direct Factor Xa Inhibitor | Direct Factor Xa Inhibitor | Direct Factor Xa Inhibitor | Direct Thrombin Inhibitor |
| Current Status | Discontinued in 2020 | Active | Active | Active |
| Availability of Reversal Agent | No FDA-approved reversal agent | Reversal agent (Andexxa) available | Reversal agent (Andexxa) available | Reversal agent (Praxbind) available |
| Approved Indications | Former: VTE prophylaxis in acutely ill patients | Multiple, including stroke prevention in AFib, DVT/PE treatment, and prophylaxis after hip/knee surgery | Multiple, including stroke prevention in AFib, DVT/PE treatment, and prophylaxis after hip/knee surgery | Multiple, including stroke prevention in AFib, DVT/PE treatment, and prophylaxis after hip surgery |
| Administration | Oral capsule, once daily (formerly) | Oral tablet, typically twice daily | Oral tablet, typically once daily | Oral capsule, typically twice daily |
Side Effects and Considerations
As an anticoagulant, betrixaban increased the risk of bleeding. Clinical trials reported common side effects including constipation, diarrhea, hypokalemia, and urinary tract infections. Serious risks included major bleeding and a boxed warning for spinal or epidural hematoma risk in patients receiving neuraxial anesthesia. Betrixaban was not advised for patients with severe renal impairment or moderate to severe hepatic impairment. Prescribing an anticoagulant requires careful evaluation of a patient's medical history and current health.
Conclusion
The generic name for the Factor Xa inhibitor previously known as Bevyxxa is betrixaban. Although discontinued in 2020 for business reasons, betrixaban played a role in the history of anticoagulant therapy. Its discontinuation underscores the ongoing development in this field, with alternatives like apixaban and rivaroxaban now widely used due to their broader approved uses and, in some cases, available reversal agents. Individuals requiring anticoagulant treatment should consult with a healthcare professional to determine the most suitable and currently available medication for their condition.
Frequently Asked Questions About Betrixaban (Bevyxxa)
- Why was Bevyxxa discontinued? The manufacturer, Portola Pharmaceuticals, voluntarily withdrew Bevyxxa (betrixaban) from the market for business reasons in 2020. The discontinuation was not related to safety or quality issues with the medication.
- What was betrixaban used for? Before its discontinuation, betrixaban was used for the prevention of venous thromboembolism (VTE) in high-risk adult patients who were hospitalized with an acute medical illness.
- Is there a reversal agent for betrixaban? No, there is no FDA-approved reversal agent specifically for betrixaban to stop its anticoagulant effects in an emergency bleeding situation. This is a major difference compared to some alternative oral anticoagulants.
- Are there generic versions of Bevyxxa available? No, since the brand-name drug Bevyxxa (betrixaban) was discontinued, no generic versions are available.
- What alternatives exist for betrixaban? Several alternative oral anticoagulants are available, including other Factor Xa inhibitors like apixaban (Eliquis) and rivaroxaban (Xarelto). Your doctor can determine the best option based on your medical history and condition.
- Did betrixaban require regular blood monitoring? No, unlike older anticoagulants such as warfarin, betrixaban and other DOACs do not require regular blood monitoring with tests like INR.
- Were there specific risks associated with betrixaban? Like all anticoagulants, betrixaban increased the risk of bleeding. A boxed warning existed for the risk of spinal or epidural hematoma for patients receiving neuraxial anesthesia or undergoing spinal puncture.
- How was betrixaban typically administered? Betrixaban was administered orally, usually once daily, and was recommended to be taken with food.
- Was the dosage of betrixaban ever adjusted? Yes, dosage adjustments were recommended for patients with moderate or severe renal impairment.
Key Takeaways
- Generic Name: The generic name for the medication formerly sold as Bevyxxa is betrixaban.
- Voluntary Discontinuation: The medication was voluntarily withdrawn from the market by its manufacturer, Portola Pharmaceuticals, in April 2020 for business reasons.
- Limited Availability: Due to its discontinuation, betrixaban is no longer available in the United States or other markets.
- Factor Xa Inhibitor: As a direct Factor Xa inhibitor, betrixaban worked by interfering with a key protein in the blood clotting process.
- Alternatives Exist: Patients previously on betrixaban were transitioned to other oral anticoagulants like apixaban (Eliquis) or rivaroxaban (Xarelto), which are widely available.
- No Reversal Agent: Unlike some modern anticoagulants, betrixaban had no specific FDA-approved reversal agent to counteract its effects in a bleeding emergency.
