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APIBAN

APIXABAN · by HIGHNOON

ANTITHROMBOTIC AGENTS Antithrombotic, Factor Xa HIGHNOON

Composition

Tab 2.5 mg/5 mg: Apixaban 2.5 mg/5 mg

Indications & Dosage

Prophylaxis of venous thromboembolism following knee replacement surgery: Adult: 2.5 mg twice daily for 10-14 days, to be started 12-24 hours after surgery. Prophylaxis of venous thromboembolism following hip replacement surgery: Adult: 2.5 mg twice daily for 32-38 days, to be started 12-24 hours after surgery. Treatment of deep-vein thrombosis, Treatment of pulmonary embolism: Adult: Initially 10 mg twice daily for 7 days, then maintenance 5 mg twice daily. Prophylaxis of recurrent deep-vein thrombosis, Prophylaxis of recurrent pulmonary embolism: Adult: 2.5 mg twice daily, following completion of 6 months anticoagulant treatment. Prophylaxis of stroke and systemic embolism in nonvalvular atrial fibrillation in patient on high risk: Adult: 5 mg twice daily, reduce dose to 2.5mg twice daily in patients with age 80 years and over or body-weight less than 61 kg, or serum creatinine 133 micromol/litre and above.

Contraindications

Active, clinically significant bleeding, antiphospholipid syndrome, risk factors for major bleeding, severe hepatic impairment, severe renal impairment with creatinine clearance less than 15 ml/minute

Precautions

Anaesthesia with postoperative indwelling epidural catheter; risk of paralysis, monitor neurological signs and wait 20-30 hours after apixaban dose before removing catheter and do not give next dose until at least 5 hours, prosthetic heart valve, risk of bleeding, mild to moderate hepatic or renal impairment.

Interactions

Antiplatelets, thrombolytics, dextran, sulfinpyrazone, vit K antagonist, strong CYP3A4/P-gp inhibitors, NSAIDs, rifampicin, phenytoin, carbamazepine, phenobarbital

Pregnancy

Caution advised, avoid

Lactation

Caution advised, avoid

Side Effects

Anaemia, haemorrhage, nausea, vomiting, skin reactions, CNS haemorrhage, hypotension, post procedural haematoma, thrombocytopenia, wound complications