Apixaban (Hematological Agent)

Question 1

What is the brand name of Apixaban?

Answer 1

Eliquis

Question 2

What strength tablets are available for Eliquis?

Answer 2

2.5mg & 5mg

Question 3

What is the FDA approved dosage for Apixaban when being used to reduce the risk of stroke and systemic embolism in nonvalvular atrial fibrillation?

Answer 3

5mg BID

Use 2.5mg BID in patients with 2 or more of the following traits:

• > 80 years old
• Weight <60kg
• Serum creatinine >1.5mg/dL

Question 4

What dose of Eliquis should be given when used as a prophylaxis of DVT following hip or knee replacement surgery?

Answer 4

2.5mg BID

Question 5

What dose of Apixaban should be given when used to treat DVT & PE?

Answer 5

10mg BID for 7 days followed by 5mg BID

Question 6

What dose of Eliquis should be given when being used to reduce the risk of recurrent DVT & PE following initial therapy?

Answer 6

2.5mg BID

Question 7

What is the mechanism of action of Apixaban?

Answer 7

Apixaban is a selective inhibitor of Factor Xa (FXa)

Question 8

What are the drug interactions of Eliquis?

Answer 8

• Apixaban exposure is increased by strong dual inhibitors of CYP3A4, & P-glycoproteins
• Exposure is decreased by CYP3A4 inducers
• Coadministration with anticoagulants and anti-platelets increase the risk ob bleeding side effects

Question 9

What are the contraindications of Apixaban?

Answer 9

• Contraindicated in patients with active pathological bleeding
• PREMATURE DC OF THERAPY INCREASES RISK OF THROMBOTIC EVENTS. USE CAUTION IN PATIENTS UNDERGOING SPINAL/EPIDURAL ANESTHESIA, ESP THOSE WITH INDWELLING EPIDURAL CATHETERS.
• Not recommended for use in patients with prosthetic heart valves
• Pregnancy Category B

Question 10

What are the adverse effects of Eliquis?

Answer 10

Adverse effects are uncommon and are primarily composed of bleeding events such as contusion, hemorrhage, hematoma, and gingival bleeding.

Question 11

What should the RPh say when counseling a patient on Apixaban?

Answer 11

• May be taken w/o regard to food
• Do not DC w/o discussing with doctor
• Inform your MD of any upcoming surgical procedures
• Do not take NSAIDs or any other drugs that increase your chance of bleeding
• Contact physician if you experience any signs of unusual bleeding (i.e. nose bleeds, bleeding gums, pink or brown urine, red or black stools, coughing to vomiting blood, or headache/dizziness
• If you miss a dose, take it ASAP. If it is about time for the next dose, skip the missed dose and return to your normal dosing schedule