Apixaban

Overview

What is Apixaban? 

Apixaban is an oral anticoagulant (“blood thinner”) that works by inhibiting Factor Xa, an important component of the blood clotting process. It comprises the active ingredient apixaban itself, a highly selective and reversible direct Factor Xa inhibitor. 

Apixaban has a chemical structure represented as C25H25N5O4 and appears as a white to pale-yellow powder. It is synthesized through complex chemical processes that ensure its high selectivity and binding affinity for Factor Xa. 

Global Name

Generic Name and Brand Names 

• Generic name: Apixaban
  
• Brand names: Eliquis

Usage

What is Apixaban used for?

Apixaban is prescribed for the following conditions: 

• To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. 
• To treat deep vein thrombosis (DVT) and pulmonary embolism (PE). 
• To prevent the recurrence of DVT and PE after initial therapy. 
• For prophylaxis of DVT, which may lead to PE in patients who have undergone hip or knee replacement surgery. 

How do you use Apixaban?

Availability:

Apixaban is available in tablet form. 

Dosage information: 

• For stroke prevention in nonvalvular atrial fibrillation: 5 mg taken orally twice a day. 
• For DVT and PE treatment: 10 mg taken orally twice daily for the first 7 days, followed by 5 mg twice daily. 
• For DVT prophylaxis after surgery: 2.5 mg taken orally twice a day. 

Suitable for: 

• Children: Safety and efficacy have not been established. 
• Adults: Yes 
• Elderlies: Yes, with caution in those with renal impairment. 

Who can't take Apixaban? 

• Children: Not recommended. 
• Adults: Those with active pathological bleeding or severe hypersensitivity to the drug or any of its components. 
• Elderlies: Caution is advised, especially with renal impairment. 
• Pregnancy and Lactation: Not recommended; use only if healthcare professionals advise.  

Allergies:

It is not suitable for those with known hypersensitivity to apixaban or any formulation components. 

Warnings and precautions:

Should be used with caution in patients with increased bleeding risk, hepatic impairment, or renal impairment. 

Apixaban can be taken with or without food. It should be swallowed whole, not crushed, chewed, or broken. 

Interactions and contraindications:

Apixaban should not be used in combination with other anticoagulants unless under medical supervision. It can interact with medications such as ketoconazole, ritonavir, and certain anticoagulants or antiplatelet agents. 

Side Effects

Common side effects include easy bleeding/bruising, anemia, and rash. Severe side effects may involve heavy internal bleeding, hematomas, and allergic reactions. 

Pharmacist Tips

• Adherence: It's crucial to take Apixaban at the same times each day as your doctor directs to maintain its effectiveness. 
• Missed Doses: If you miss a dose, take it as soon as you remember on the same day. Don’t double the next dose to catch up. 
• Interactions: Inform healthcare providers about Apixaban use before any procedures and check with your pharmacist before starting new medications or supplements. 
• Side Effects: Report any unusual bruising or bleeding to your doctor immediately. 
• Travel: Keep medication in its original bottle and carry an extra supply when traveling.
• Storage: Store Apixaban at room temperature away from moisture and heat, and keep it out of reach of children. 
  
  By maintaining consistent dosing, being aware of drug interactions and side effects, and properly storing and handling Apixaban, you can safely manage your treatment. Always consult a healthcare professional for any concerns or questions regarding your medication. 

Availability

Where is Apixaban available in Hong Kong?

Apixaban is a prescription medication that can be prescribed by healthcare providers.

FAQs

Is Apixaban for purchase over-the-counter?

No, Apixaban is a prescription medication that a healthcare provider must prescribe.

Can you drink alcohol while taking Apixaban?

Alcohol may increase the bleeding risk; consult your healthcare provider for personalized advice.

What should you do if you miss a dose of Apixaban?

If you miss a dose, take it as soon as you remember on the same day. Do not take two doses on the same day to make up for the missed dose.

How long should Apixaban be stopped before surgery?  

Apixaban is typically stopped at least 24 hours (for low-risk for bleeding e.g. minor dental procedures) and 48 hours (for high-risk for bleeding e.g. hip & spine surgery) before surgery, but individual recommendations may vary based on bleeding risk and kidney function; consult a healthcare provider for specific guidance.