User:ImaanI23/sandbox

Indications and Use

Apixaban is indicated for the following:


 * To lower the risk of stroke and embolism in patients with nonvalvular atrial fibrillation.
 * Deep vein thrombosis (DVT) prophylaxis. DVT's may lead to pulmonary embolism (PE) in knee or hip replacement surgery patients.
 * Treatment of both deep vein thrombosis (DVT) and pulmonary embolism (PE).
 * To reduce the risk of reoccurring DVT and PE after initial therapy.

Dosage forms and Strengths

Apixaban is available in:


 * 2.5mg, round YELLOW, film-coated tablets with "893" on one side and "2 1/2" on the other side.
 * 5mg, oval-shaped PINK, film-coated tablets with "894" on one side and "5" on the other side.

Recommended Dosages

For lowering risk of stroke and embolism in nonvalvular atrial fibrillation patients:
 * Take 5mg orally two times a day

For DVT prophylaxis after knee or hip replacement surgery:
 * Initial dose should be taken 12 to 24 hours after surgery
 * Take 2.5mg orally two times a day
 * For Hip Replacement surgery: recommended duration of treatment is 35 days.
 * For Knee Replacement surgery: recommended duration of treatment is 12 days.

For Treatment of DVT/PE:
 * Take 10mg orally two times a day for 7 days, followed by 5mg orally two times a day

For reducing the risk of reoccurring DVT and PE after initial therapy:
 * Take 2.5mg orally two times a day after a minimum of 6 months of initial therapy for DVT/PE.

Dose Adjustments

For any patient with any 2 of the following, the recommended apixaban dose is 2.5mg orally two times a day:
 * Age 80 or over
 * Body weight of 60kg or less
 * Serum Creatinine of 1.5 mg/dL or greater

Coadministration with CYP3A4 and P-gp inhibitors:

The dose for apixaban when giving it along with drugs that are strong dual inhibitors of cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) (e.g. clarithromycin, itraconazole, ketoconazole, ritonavir) is 2.5mg orally two times a day.

Adverse Reactions

Discontinuing apixaban early without alternative anti coagulation can increase the risk of thrombotic events. In clinical trials, atrial fibrillation patients had an increased rate of stroke when switching from apixaban to warfarin. If apixaban is stopped for a reason other than bleeding or completion of course of therapy, consider using another anti coagulation. Apixaban can increase the risk of bleeding and may even cause serious, potentially fatal, bleeding. Concurrent use with drugs affecting hemostasis (e.g. other anticoagulants, heparin, aspirin and other antiplatelet drugs, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs)) can further increase the risk of bleeding. When spinal/epidural anesthesia or puncture is utilized, patients who are being treated with anti-thrombotic agents for the prevention of thromboembolic complications are at risk for developing a hematoma, which can cause long-term or permanent paralysis. The risk of this may be increased by using epidural or intrathecal catheters after a surgical operation or from the concurrent use of medicinal agents that affect hemostasis.
 * Higher risk of thrombotic events after discontinuing apixaban treatment prematurely
 * Bleeding
 * Spinal/epidural anesthesia or puncture