"Fewer than half of patients with atrial fibrillation adhere to their anticoagulant regimen in a real clinical-practice setting, even if prescribed one of the new oral anticoagulants (NOACs) rather than a vitamin-K antagonist such as warfarin, a c"...
Reduction Of Risk Of Stroke And Systemic Embolism In Nonvalvular Atrial Fibrillation
ELIQUIS® (apixaban) is indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.
Prophylaxis Of Deep Vein Thrombosis Following Hip Or Knee Replacement Surgery
Treatment Of Deep Vein Thrombosis
ELIQUIS is indicated for the treatment of DVT.
Treatment Of Pulmonary Embolism
ELIQUIS is indicated for the treatment of PE.
Reduction In The Risk Of Recurrence Of DVT And PE
ELIQUIS is indicated to reduce the risk of recurrent DVT and PE following initial therapy.
DOSAGE AND ADMINISTRATION
Reduction of Risk of Stroke and Systemic Embolism in Patients with Nonvalvular Atrial Fibrillation
The recommended dose of ELIQUIS for most patients is 5 mg taken orally twice daily.
The recommended dose of ELIQUIS is 2.5 mg twice daily in patients with at least two of the following characteristics:
- age ≥ 80 years
- body weight ≤ 60 kg
- serum creatinine ≥ 1.5 mg/dL
Prophylaxis of Deep Vein Thrombosis Following Hip or Knee Replacement Surgery
The recommended dose of ELIQUIS 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 ELIQUIS 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 ELIQUIS is 2.5 mg taken orally twice daily after at least 6 months of treatment for DVT or PE [see Clinical Studies].
If a dose of ELIQUIS 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
ELIQUIS 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. ELIQUIS 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 ELIQUIS and prior to the intervention is not generally required. ELIQUIS should be restarted after the surgical or other procedures as soon as adequate hemostasis has been established.
Converting From Or To ELIQUIS
Switching From Warfarin to ELIQUIS
Warfarin should be discontinued and ELIQUIS started when the international normalized ratio (INR) is below 2.0.
Switching from ELIQUIS to Warfarin
ELIQUIS 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 ELIQUIS and begin both a parenteral anticoagulant and warfarin at the time the next dose of ELIQUIS would have been taken, discontinuing the parenteral anticoagulant when INR reaches an acceptable range.
Switching from ELIQUIS to Anticoagulants Other Than Warfarin (Oral Or Parenteral)
Discontinue ELIQUIS and begin taking the new anticoagulant other than warfarin at the usual time of the next dose of ELIQUIS.
Switching From Anticoagulants Other Than Warfarin (Oral Or Parenteral) to ELIQUIS
Discontinue the anticoagulant other than warfarin and begin taking ELIQUIS at the usual time of the next dose of the anticoagulant other than warfarin.
Strong Dual Inhibitors Of CYP3A4 And P-glycoprotein
For patients receiving ELIQUIS doses of 5 mg or 10 mg twice daily, reduce the dose by 50% when ELIQUIS is coadministered with drugs that are strong dual inhibitors of cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) (e.g., ketoconazole, itraconazole, ritonavir, clarithromycin) [see CLINICAL PHARMACOLOGY]. In patients already taking 2.5 mg twice daily, avoid coadministration of ELIQUIS with strong dual inhibitors of CYP3A4 and P-gp [see DRUG INTERACTIONS].
For patients who are unable to swallow whole tablets, 5 mg and 2.5 mg ELIQUIS tablets may be crushed and suspended in 60 mL D5W and immediately delivered through a nasogastric tube (NGT) [see CLINICAL PHARMACOLOGY]. Information regarding the administration of crushed and suspended ELIQUIS tablets swallowed by mouth is not available.
Dosage Forms And Strengths
- 2.5 mg, yellow, round, biconvex, film-coated tablets with “893” debossed on one side and “2½” on the other side.
- 5 mg, pink, oval-shaped, biconvex, film-coated tablets with “894” debossed on one side and “5” on the other side.
ELIQUIS (apixaban) tablets are available as listed in the table below.
|Tablet Strength||Tablet Color/ Shape||Tablet Markings||Package Size||NDC Code|
|2.5 mg||Yellow, round, biconvex||Debossed with “893” on one side and “2/” on the other side||Bottles of 60||0003-0893-21|
|Bottles of 180||0003-0893-41|
|Hospital Unit-Dose Blister Package of 100||0003-0893-31|
|5 mg||Pink, oval, biconvex||Debossed with “894” on one side and “5” on the other side||Bottles of 60||0003-0894-21|
|Bottles of 180||0003-0894-41|
|Hospital Unit-Dose Blister Package of 100||0003-0894-31|
Storage And Handling
Store at 20°C to 25°C (68°F-77°F); excursions permitted between 15°C and 30°C (59°F-86°F) [see USP Controlled Room Temperature].
Marketed by: Bristol-Myers Squibb Company, Princeton, New Jersey 08543 USA and Pfizer Inc, New York, New York 10017 USA. Revised June 2015This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 3/2/2016
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