Apixaban: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: [[Anticoagulant]] | *Type: [[Anticoagulant]] | ||
*Dosage Forms: | *Dosage Forms: tablet | ||
*Dosage Strengths: 2.5mg, 5mg | |||
*Routes of Administration: Oral | *Routes of Administration: Oral | ||
*Common Trade Names: Eliquis | *Common Trade Names: Eliquis | ||
==Adult Dosing== | ==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 [[DVT]] prophylaxis after hip or knee arthroplasty=== | |||
*2.5mg BID | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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===Serious=== | ===Serious=== | ||
*Major bleeding (GI, muscular, epidural, intracranial, conjunctival, urinary, intraoperative) | *Major bleeding (GI, muscular, epidural, intracranial, conjunctival, urinary, intraoperative) | ||
***[[Anticoagulant reversal for life-threatening bleeds|Bleeding, severe]] | |||
****[[Andexanet alfa]] | |||
*LFT abnormalities | *LFT abnormalities | ||
===Common=== | ===Common=== | ||
*Easy bruising, hematoma, gingival bleeding, menorrhagia, epistaxis | *Easy bruising, hematoma, gingival bleeding, menorrhagia, epistaxis | ||
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*Half-life: 7-16 hours | *Half-life: 7-16 hours | ||
*Metabolism: Hepatic, mainly CYP3A4 | *Metabolism: Hepatic, mainly CYP3A4 | ||
*Excretion: | *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== | ==Mechanism of Action== | ||
*Reversible factor Xa | *Reversible factor Xa inhibitor→ decreased thrombin synthesis | ||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Andexanet alfa]] | |||
*[[Anticoagulant reversal for life-threatening bleeds]] | *[[Anticoagulant reversal for life-threatening bleeds]] | ||
*[[Procedures in patients with coagulopathies]] | *[[Procedures in patients with coagulopathies]] | ||
*[[PE]] | *[[PE]] | ||
*[[DVT]] | *[[DVT]] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Latest revision as of 22:21, 7 June 2023
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 DVT prophylaxis 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
- Andexanet alfa
- Anticoagulant reversal for life-threatening bleeds
- Procedures in patients with coagulopathies
- PE
- DVT