DOAC·Haematology - Anticoagulants & Haemostatics

Apixaban

Stroke prevention in non-valvular AF, treatment and prevention of DVT/PE

Authority requiredPBSDOACEliquis2.5 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

5 mg BD

Half-life

12 h

Caution: Bleeding Risk

HIGH

Monitoring

ROUTINE NOT REQ.

Cautions

Avoid / Cautions

Mechanical heart valves, moderate-to-severe mitral stenosis, active bleeding. Pregnancy Category C.

Where it stands

Rapid Summary

Overview

Direct Factor Xa inhibitor. Often preferred for the elderly due to the lowest rate of GI bleeding among the DOACs and lower reliance on renal clearance.

Clinical Focus

Requires strict BD dosing. If the patient is prone to forgetting doses, Rivaroxaban (OD) is a safer option.

Bottom Line

Apixaban is the DOAC with the best bleeding profile and is preferred in elderly and renally impaired patients, but requires twice-daily dosing and has limited options for reversal.

Formulation & Access

Brand Names

Eliquis

Oral Routes

Tablets (2.5 mg, 5 mg). Taken with or without food.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Stroke prevention in non-valvular AF, treatment and prevention of DVT/PE.

Clinical Place

Often the first-line DOAC choice in WA Health for frail, elderly patients due to superior safety profile (ARISTOTLE trial).

Quick reference

Class & Role

DOAC — Direct Factor Xa inhibitor.

Route / Formulation

Tablets (2.5 mg, 5 mg). Taken with or without food. (Eliquis)

Usual Dose & Max

PO 5 mg BD. Max 5 mg BD.

Key Indication Doses

Non-Valvular AF: PO 5 mg BD. AF Dose Reduction: Reduce to 2.5 mg BD if the patient meets TWO of the following: Age ≥ 80, Weight ≤ 60 kg, Creatinine ≥ 133 micromol/L. Acute VTE / DVT / PE: PO 10 mg BD for 7 days, then 5 mg BD.

Best Uses

Apixaban is the DOAC with the best bleeding profile and is preferred in elderly and renally impaired patients, but requires twice-daily dosing and has limited options for reversal.

Key Risks

Haematological: Major haemorrhage (Though statistically lower risk of fatal bleeding compared to Warfarin and Rivaroxaban). Gastrointestinal: Nausea.

Key Interactions

Strong combined inhibitors of CYP3A4 and P-gp (Ketoconazole, Clarithromycin). Avoid combination. NSAIDs, SSRIs.

Monitoring

U&E and eGFR at baseline to calculate the 'Two of Three' rule. No routine INR/aPTT needed. Monitor for bleeding.

Clinical Pearl

Never dose-reduce to 2.5mg BD 'just to be safe'. Unless the patient meets exactly TWO of the three criteria (Age>80, Wt<60, Cr>133) or has severe renal failure, sub-therapeutic dosing significantly increases stroke risk.

Access

Authority requiredEliquis2.5 mg tablet

Brand: Eliquis
PBS status: Authority required
Formulation: Tablets (2.5 mg, 5 mg). Taken with or without food.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

DOAC·Haematology - Anticoagulants & Haemostatics

Apixaban

Stroke prevention in non-valvular AF, treatment and prevention of DVT/PE

Authority requiredPBSDOACEliquis2.5 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

5 mg BD

Half-life

12 h

Caution: Bleeding Risk

HIGH

Monitoring

ROUTINE NOT REQ.

Cautions

Avoid / Cautions

Mechanical heart valves, moderate-to-severe mitral stenosis, active bleeding. Pregnancy Category C.

Where it stands

Rapid Summary

Overview

Direct Factor Xa inhibitor. Often preferred for the elderly due to the lowest rate of GI bleeding among the DOACs and lower reliance on renal clearance.

Clinical Focus

Requires strict BD dosing. If the patient is prone to forgetting doses, Rivaroxaban (OD) is a safer option.

Bottom Line

Apixaban is the DOAC with the best bleeding profile and is preferred in elderly and renally impaired patients, but requires twice-daily dosing and has limited options for reversal.

Formulation & Access

Brand Names

Eliquis

Oral Routes

Tablets (2.5 mg, 5 mg). Taken with or without food.

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Stroke prevention in non-valvular AF, treatment and prevention of DVT/PE.

Clinical Place

Often the first-line DOAC choice in WA Health for frail, elderly patients due to superior safety profile (ARISTOTLE trial).

Quick reference

Class & Role

DOAC — Direct Factor Xa inhibitor.

Route / Formulation

Tablets (2.5 mg, 5 mg). Taken with or without food. (Eliquis)

Usual Dose & Max

PO 5 mg BD. Max 5 mg BD.

Key Indication Doses

Best Uses

Apixaban is the DOAC with the best bleeding profile and is preferred in elderly and renally impaired patients, but requires twice-daily dosing and has limited options for reversal.

Key Risks

Haematological: Major haemorrhage (Though statistically lower risk of fatal bleeding compared to Warfarin and Rivaroxaban). Gastrointestinal: Nausea.

Key Interactions

Strong combined inhibitors of CYP3A4 and P-gp (Ketoconazole, Clarithromycin). Avoid combination. NSAIDs, SSRIs.

Monitoring

U&E and eGFR at baseline to calculate the 'Two of Three' rule. No routine INR/aPTT needed. Monitor for bleeding.

Clinical Pearl

Access

Authority requiredEliquis2.5 mg tablet

Brand: Eliquis
PBS status: Authority required
Formulation: Tablets (2.5 mg, 5 mg). Taken with or without food.

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.