apixaban, Eliquis
GENERIC NAME: apixaban
BRAND NAME: Eliquis
DRUG CLASS AND MECHANISM: Eliquis is an oral drug used for preventing blood clots in patients with atrial fibrillation. It is an anticoagulant that works by blocking the action of factor Xa. Factor Xa is an important protein in the coagulation cascade that causes blood to clot. Reducing the action of factor Xa reduces the ability of blood to clot. In patients with atrial fibrillation there is increased risk of blood clots which can travel to the brain where it causes strokes as well as to other organs. Eliquis reduces this risk. The FDA approved Eliquis in December 2012.PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 2.5 and 5 mg
STORAGE: Apixaban should be stored at room temperature between 15 C to 30 C (59 F to 86 F).
PRESCRIBED FOR: Eliquis is used for reducing the risk of strokes and blood clots in patients with atrial fibrillation who have no problems with their heart valve (nonvalvular atrial fibrillation).
DOSING: The usually recommended dose is 5 mg by mouth twice daily. The dose for individuals 80 years or older, weighing less than or equal to 60 kg, or with reduced kidney function is 2.5 mg twice daily.
DRUG INTERACTIONS: Blood levels of apixaban are increased by drugs that reduce the activity of the liver enzymes that break down apixaban. The dose of apixaban should be reduced to 2.5 mg twice daily if combined with drugs that reduce the activity of these enzymes. Examples include ketoconazole (Nizoral, Extina, Xolegel, Kuric), itraconazole (Sporanox), ritonavir (Norvir), and clarithromycin (Biaxin, Biaxin XL).
Drugs that increase the breakdown of apixaban reduce its blood levels and its effectiveness. Examples include carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol), rifampin, St. John's Wort, and phenytoin (Diantin, Dilantin-125. They should not be combined with apixaban.
Administration of other drugs that also can prevent clotting will increase the risk of bleeding during treatment with apixaban. Examples include aspirin, heparin, chronic use of NSAIDs, and drugs that breakdown blood clots (fibrinolytics).
PREGNANCY: There are no adequate studies in pregnant women. Use during pregnancy may increase the risk of bleeding during pregnancy and delivery.
NURSING MOTHERS: It is not known if apixaban is excreted in human milk. Nursing mothers should discontinue apixaban or discontinue nursing.
SIDE EFFECTS: The most common side effects of apixaban involve bleeding. These include bleeding in the stomach, intestines, brain, and eyes; the bleeding may be fatal. Major bleeding events were fewer in patients who received apixaban when compared to a similar group that received warfarin (Coumadin), another widely used drug for preventing blood clots. Rash and serious allergic reactions also may occur.
