Apixaban T300 26-27

Apixaban

Eliquis

Apixaban Drug Class

Factor Xa Inhibitor

Apixaban Dosage Forms

Oral Tablet: 2.5 mg, 5 mg
Oral Tablet Therapy Pack: 5 mg (74 tablets)

Apixaban Dosing By Indication

1. Atrial fibrillation, nonvalvular (prophylaxis to reduce risk of stroke): 5 mg po bid

2. Hip or knee replacement surgery (prophylaxis to reduce risk of DVT and PE): 2.5 mg po bid × 12 d (knee replacement) or 35 d (hip replacement); start 12–24 h postoperatively

3. DVT or PE (treatment and to reduce future risk): 10 mg po bid × 7 d, then 5 mg po bid

Apixaban Off Label Uses

1. Heparin-induced thrombocytopenia with thrombosis in hemodynamically stable patients or after initial therapy with a parenteral nonheparin anticoagulant: with thrombosis, 10 mg po bid × 7 d, then 5 mg po bid; without thrombosis, 5 mg po bid

Apixaban MOA

This drug selectively inhibits factor Xa, resulting in decreased thrombin generation and reduced thrombus development.

Apixaban Common Adverse Effects

Bleeding

Apixaban Efficacy Monitoring Parameters

Absence of thrombosis when used for prophylaxis; absence of stroke in atrial fibrillation; resolution of DVT or PE when used for treatment.

Apixaban Safety Monitoring Parameters

Hepatic and renal function; assess for signs and symptoms of bleeding.

Apixaban Key Counseling Points

Seek medical attention for unexpected bleeding or trouble breathing. May take with or without food. Do not stop therapy without consulting a health-care provider, as premature discontinuation increases stroke risk in atrial fibrillation. Hold therapy 24–48 h prior to dental or surgical procedures and restart after hemostasis. Avoid OTC NSAIDs and high-dose aspirin due to increased bleeding risk.

Apixaban Clinical Pearls

Factor Xa inhibitors do not require routine INR monitoring and have a lower bleeding risk compared with warfarin, while offering oral administration convenience. Specific recommendations exist for converting from other anticoagulants. FDA labeling does not require dose adjustment for renal dysfunction for indications other than atrial fibrillation; however, patients with Cr​Cl