Apixaban
Administration
- Type: Anticoagulant
- Dosage Forms: tablet
- Dosage Strengths: 2.5mg, 5mg
- Routes of Administration: Oral
- Common Trade Names: Eliquis
Adult Dosing
- Pulmonary embolism, DVT: 10mg PO twice daily x 7 days, then 5mg BID
- Stroke prevention in afib: 5mg PO BID. Reduce the dose to 2.5 mg PO BID if patient has any 2 of the following: Age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL.
- Post-op DVTprophylaxis after hip or knee arthroplasty: 2.5mg BID
Pediatric Dosing
Safety/efficacy not established
Special Populations
- Pregnancy Rating: B
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: No adjustment for DVT/PE treatment. Afib: 2.5mg BID if creatinine >1.5
- Hepatic dosing: No adjustment for mild impairment. Not recommended if severe impairment.
- Decrease dose if concomitant use of CYP3A4 and P-gp efflux dual inhibitors
Contraindications
- Allergy to class/drug
- Active bleeding
Adverse Reactions
Serious
- Major bleeding (GI, muscular, epidural, intracranial, conjunctival, urinary, intraoperative)
- LFT abnormalities
Common
- Easy bruising, hematoma, gingival bleeding, menorrhagia, epistaxis
Pharmacology
- Half-life: 7-16 hours
- Metabolism: Hepatic, mainly CYP3A4
- Excretion: 25% in urine and feces as metabolites; renal excretion accounts for 27%T of total clearance; biliary and direct intestinal excretion contributes to elimination in feces
Mechanism of Action
- Reversible factor Xa inhibitor→ decreased thrombin synthesis
Comments
See Also
References
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