Apixaban
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Apixaban
Eliquis
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Summary
Common uses
Stroke prevention in nonvalvular atrial fibrillation0, VTE treatment0, VTE prophylaxis after hip/knee replacement0
Pharmacy
Starting dose
NVAF: 5 mg PO BID (2.5 mg BID if 2 of 3: age ≥80, weight ≤60 kg, serum creatinine ≥1.5 mg/dL); acute VTE: 10 mg BID for 7 days, then 5 mg BID
Preparations
2.5 mg, 5 mg tablets
US FDA Max
10 mg BID for the first 7 days of acute VTE; otherwise 5 mg BID
Pharmacology
Routes
Oral
Onset
Peak anticoagulant effect 3-4 hours
Duration
12 hours
Half-life
~12 hours[1]
Bioavailability
~50% (oral; not significantly affected by food)[1]
Pregnancy
Avoid in pregnancy; switch to LMWH. Crosses placenta; data are limited but warfarin-class concerns about fetal hemorrhage and possible teratogenicity make heparins the preferred class.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Apixaban is a selective reversible direct inhibitor of activated factor X (Xa); blocking Xa interrupts thrombin generation at a stoichiometrically efficient point in the coagulation cascade, producing predictable anticoagulation without routine monitoring.0 CYP3A4 (primary) and P-glycoprotein substrate; strong dual inhibitors or inducers materially shift exposure. Reversal: andexanet alfa for life-threatening bleeding; 4F-PCC commonly used off-label when andexanet unavailable[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Eliquis (apixaban), Bristol-Myers Squibb, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/202155s029lbl.pdf