Other Names/Brands

The currently available brand in Indonesia that contains apixaban is Eliquis.

Mechanism of Action

Apixaban is an anticoagulant commonly prescribed to prevent blood clotting problems such as venous thromboembolism in patients who have undergone hip or knee replacement surgery. This medicine works by inhibiting the formation of thrombin, an important component in the blood clotting process, so that the formation of thrombi or blood clots can be controlled.

Indications

Apixaban is used to treat conditions such as the prevention of venous thromboembolism, systemic embolism or stroke in heart rhythm disorders like non-valvular atrial fibrillation, and for the treatment of deep vein thrombosis and pulmonary embolism.

Contraindications

Contraindications to the use of apixaban include active bleeding, liver disease associated with coagulopathy, other conditions that increase the risk of bleeding, gastrointestinal bleeding, gastric ulcers, and concomitant use with other anticoagulant medications.

Side Effects

Side effects usually occur infrequently. However, some reactions that may appear include hematuria, urinary tract bleeding, nosebleeds, nausea, vomiting, bleeding from the mouth and gums, gastrointestinal bleeding, anemia, and thrombocytopenia (low platelet count).

Preparations

Apixaban preparations that are currently available include:

• 2.5 mg film-coated tablets

Dosage

Prevention of venous thromboembolism

• Adult dosage: 2.5 mg twice daily, started 12-24 hours after surgery. The treatment duration is 10-14 days for knee replacement surgery or 32-38 days for hip replacement surgery.

Treatment of deep vein thrombosis

• Adult dosage: 10 mg twice daily for the first 7 days, followed by 5 mg twice daily.

Prevention of stroke in atrial fibrillation

• Adult dosage: 5 mg twice daily.

Safety of Drugs

Pregnancy:

Apixaban is classified as FDA category B in pregnancy (animal studies have not shown harm to the fetus caused by this drug, and there are no adequate and well-controlled studies in pregnant women). Its use in pregnancy should be carefully considered, but it is generally regarded as relatively safe for pregnant women.

Drug Interactions

Potent enzyme-inducing drugs such as rifampin, phenobarbital, and phenytoin

Concomitant use of apixaban and these drugs may reduce apixaban serum levels. The use of these drugs require close monitoring by a doctor to ensure that the anticoagulant effect remains adequate.

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