Apixaban (Eliquis)

General information

Class/mechanism: Selective and reversible factor Xa inhibitor. By inhibiting free and clotbound factor Xa in the coagulation cascade, apixaban inhibits prothrombinase activity, the conversion of prothrombin to thrombin, and the subsequent conversion of fibrinogen to fibrin. It does not need antithrombin III to exert its antithrombotic activity.
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Reversal information

Andexanet alfa (Andexxa) can bind, sequester, and reverse the anticoagulation effect of rivaroxaban and apixaban.

Diseases for which it is used

• Atrial fibrillation
• Venous thromboembolism

Patient drug information

• Apixaban (Eliquis) package insert
• Apixaban (Eliquis) patient drug information (UpToDate)

History of changes in FDA indication

• 2012-12-28: Approved to reduce the risk of stroke and dangerous blood clots (systemic embolism) in patients with atrial fibrillation that is not caused by a heart valve problem. (Non-hematologic indication)
• 2014-03-13: Approved for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.
• 2014-08-21: Approved for the treatment of DVT and PE, and for the reduction in the risk of recurrent DVT and PE following initial therapy.

History of changes in EMA indication

• 2011-05-18: Initial authorization

History of changes in PMDA indication

• 2015-12-21: New additional indication and a new dosage for the treatment and prevention of the recurrence of venous thromboembolism (deep vein thrombosis and pulmonary thromboembolism).

Also known as

• Brand name: Eliquis