|Generic Name of Product||Brand Name||Dosage Form||Strength||Pharmacologic Group||Therapeutic Group||Unit Per Pack|
|Apixaban||-||Tablet||2.5 , 5 mg||Low molecular weight heparin||Anticoagulant|
Indications And Usage
Reduction of Risk of Stroke and Systemic Embolism in Nonvalvular Atrial Fibrillation
Reduction of Risk of Stroke and Systemic Embolism in Patients with Nonvalvular Atrial Fibrillation:
The recommended dose of APIXABAN for most patients is 5 mg taken orally twice daily.
The recommended dose of APIXABAN is 2.5 mg twice daily in patients with at least two of the following characteristics:
• age greater than or equal to 80 years
• body weight less than or equal to 60 kg
• serum creatinine greater than or equal to 1.5 mg/dL
Prophylaxis of Deep Vein Thrombosis Following Hip or Knee Replacement Surgery:
The recommended dose of APIXABAN is 2.5 mg taken orally twice daily. The initial dose should be taken 12 to 24 hours after surgery.
• In patients undergoing hip replacement surgery, the recommended duration of treatment is 35 days.
• In patients undergoing knee replacement surgery, the recommended duration of treatment is 12 days.
Treatment of DVT and PE:
The recommended dose of APIXABAN is 10 mg taken orally twice daily for the first 7 days of therapy. After 7 days, the recommended dose is 5 mg taken orally twice daily.
Reduction in the Risk of Recurrence of DVT and PE:
The recommended dose of APIXABAN is 2.5 mg taken orally twice daily after at least 6 months of treatment for DVT or PE
If a dose of APIXABAN is not taken at the scheduled time, the dose should be taken as soon as possible on the same day and twice-daily administration should be resumed. The dose should not be doubled to make up for a missed dose.
Temporary Interruption for Surgery and Other Interventions:
APIXABAN should be discontinued at least 48 hours prior to elective surgery or invasive procedures with a moderate or high risk of unacceptable or clinically significant bleeding. APIXABAN should be discontinued at least 24 hours prior to elective surgery or invasive procedures with a low risk of bleeding or where the bleeding would be non-critical in location and easily controlled. Bridging anticoagulation during the 24 to 48 hours after stopping APIXABAN and prior to the intervention is not generally required. APIXABAN should be restarted after the surgical or other procedures as soon as adequate hemostasis has been established.
Converting from or to APIXABAN :
Switching from warfarin to APIXABAN : Warfarin should be discontinued and APIXABAN started when the international normalized ratio (INR) is below 2.0.
Switching from APIXABAN to warfarin: APIXABAN affects INR, so that initial INR measurements during the transition to warfarin may not be useful for determining the appropriate dose of warfarin. One approach is to discontinue APIXABAN and begin both a parenteral anticoagulant and warfarin at the time the next dose of APIXABAN would have been taken, discontinuing the parenteral anticoagulant when INR reaches an acceptable range.
Switching from APIXABAN to anticoagulants other than warfarin (oral or parenteral): Discontinue APIXABAN and begin taking the new anticoagulant other than warfarin at the usual time of the next dose of APIXABAN .
Switching from anticoagulants other than warfarin (oral or parenteral) to APIXABAN : Discontinue the anticoagulant other than warfarin and begin taking APIXABAN at the usual time of the next dose of the
For patients who are unable to swallow whole tablets, 5 mg and 2.5 mg APIXABAN tablets may be crushed and suspended in water, 5% dextrose in water (D5W), or apple juice, or mixed with applesauce and promptly administered orally Alternatively, APIXABAN tablets may be crushed and suspended in 60 mL of water or D5W and promptly delivered through a nasogastric tube.
Crushed APIXABAN tablets are stable in water, D5W, apple juice, and applesauce for up to 4 hours.
Active pathological bleeding , Severe hypersensitivity reaction to APIXABAN
Increased Risk of Thrombotic Events after Premature Discontinuation:
Increased risk of thrombotic events after premature discontinuation, Bleeding , Spinal/epidural anesthesia or puncture.
Pregnancy and lactation
• Pregnancy: Not recommended.
• Lactation: Discontinue drug or discontinue nursing.
Renal and liver Impairment
Severe Hepatic Impairment: Not recommended.