Apixaban

Revision as of 20:15, 15 August 2018 by Mrosen5506 (talk | contribs) (Serious)
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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

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