Apixaban (Eliquis®) Considerations for Use*
US/FDA Approved Indications: Stroke Prevention in Non-valvular Atrial Fibrillation
|Black Box Warning*||Discontinuing apixaban in patients with atrial fib and without adequate continuous anticoagulation increases the risk of thrombotic events.|
Mechanism of Action
Direct factor Xa inhibitor
Adult: 5 mg PO twice daily
With at least 2 of the following : age ≥ 80 years , body weight ≤ 60 kg, serum creatinine ≥ 1.5 mg/d L: 2.5 mg PO twice daily
With strong dual inhibitors of CYP3A4 and P-gp, (e.g., ketoconazole, itraconazole, ritonavir, or clarithromycin): decrease dose of apixaban to 2.5 mg twice daily or do not use apixaban
Hepatic Impairment: Not studied with severe hepatic impairment
Renal Impairment: CrCl < 15 mL/min or on dialysis: not recommended
Active pathological bleeding , prosthetic heart valve
|Major Side Effects||
|Dosage forms and Strengths||
PO: 2.5 , 5 mg tablets
There is no rapid reversal agent for apixaban. Drug levels may persist for ~24 hours after last dose (i.e., 2 half lives).
Surgery and interventions:
|Conversion to/from other drugs||
From apixaban to warfarin:
From warfarin to apixaban:
Switching between apixaban and an anticoagulant other than warfarin:
Has many potential drug interactions.
Do not discontinue this medication without talking to the healthcare provider who prescribed it.
Consult healthcare professional prior to using new drug (prescription, OTC, herbal). Report signs and symptoms of bleeding (e.g., unexpected bleeding or bleeding that lasts a long time; red or black, tarry stool; pink or brown urine; unusual bruising; coughing up blood; vomiting blood or vomit that looks like coffee grounds; unexplained pain, swelling, or joint pain; unusual headaches, dizziness, or weakness; recurring nose bleeds)
Tell your healthcare professi onal if you have had or will have surgery to place a prosthetic heart valve.
Tell your healthcare professional if you are pregnant or plan to become pregnant or are breastfeeding or plan to breastfeed during treatment.
*Refer to prescribing information for more complete information.
†Dosages given in the table may differ from those recommended by the manufacturers.
- Eliquis® Prescribing information, 12/28/12 .