apixaban

Apixaban is an anticoagulant (blood thinner) used for reducing the risk of blood clots in the heart and strokes in patients with atrial fibrillation who have no problems with their heart valves (nonvalvular atrial fibrillation). Apixaban is also used to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients who have undergone hip or knee replacement surgery.

• Apixaban is used for reducing the risk of blood clots in the heart and strokes in patients with atrial fibrillation who have no problems with their heart valves (nonvalvular atrial fibrillation).
• It also is used for treating and preventing deep venous thrombosis (DVT) and pulmonary embolism in patients who have undergone hip or knee replacement surgery.

The most common side effects of apixaban involves bleeding in the:

• stomach,
• intestines,
• brain, and
• eyes.

Bleeding due to apixaban may be fatal.

Major bleeding events were fewer in patients who received apixaban when compared to a similar group that received warfarin (Jantoven), another widely used drug for preventing blood clots.

Rash and serious allergic reactions also may occur.

• The usual dose in nonvalvular atrial fibrillation is 5 mg by mouth twice daily. For individuals 80 years or older, weighing less than or equal to 60 kg, or with reduced kidney function, the usual dose is 2.5 mg twice daily.
• The recommended dose for treating DVT or pulmonary embolism is 10 mg twice daily for the first 7 days and then 5 mg twice daily. After six months of treatment, the dose may be reduced to 2.5 mg daily for prevention of DVT or pulmonary embolism.
• When apixaban is used to prevent the risk of DVT after hip or knee replacement surgery, the suggested dose is 2.5 mg daily beginning 12 to 24 hours after the surgery is completed.

Apixaban is a blood thinner medicine that reduces blood clotting. You may have a higher risk of bleeding if you take apixaban and take other medicines that increase your risk of bleeding, including:

• aspirin or aspirin-containing products
• long-term (chronic) use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• warfarin (Jantoven)
• any medicine that contains heparin
• selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)
• other medicines to help prevent or treat blood clots

Tell your doctor if you take any of these medicines. Many other drugs may interact with apixaban, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here. Tell your doctor, dentist, and pharmacist of all drugs and supplements you take.

Spinal or epidural blood clots (hematoma)

People who take a blood thinner medicine (anticoagulant) like apixaban, and have medicine injected into their spinal and epidural area, or have a spinal puncture have a risk of forming a blood clot that can cause long-term or permanent loss of the ability to move (paralysis). Your risk of developing a spinal or epidural blood clot is higher if:

• a thin tube called an epidural catheter is placed in your back to give you certain medicine
• you take NSAIDs or a medicine to prevent blood from clotting
• you have a history of difficult or repeated epidural or spinal punctures
• you have a history of problems with your spine or have had surgery on your spine

If you take apixaban and receive spinal anesthesia or have a spinal puncture, your doctor should watch you closely for symptoms of spinal or epidural blood clots or bleeding. Tell your doctor right away if you have tingling, numbness, or muscle weakness, especially in your legs and feet.

• There are no adequate studies in pregnant women. Use during pregnancy may increase the risk of bleeding during pregnancy and delivery. Apixaban should be avoided during pregnancy.
• It is not known if apixaban is excreted in human milk. Nursing mothers should discontinue apixaban or discontinue nursing.

What preparations of apixaban are available?

• Tablets: 2.5 and 5 mg

How should I keep apixaban stored?

• Apixaban should be stored at room temperature, between 15 C and 30 C (59 F and 86 F).