Apixaban (Eliquis®)
Biochemistry
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Apixaban is a drug used to inhibit blood clotting. The mechanism of action of apixaban is that it directly and highly selectively inhibits factor Xa, independently of antithrombin. The substance is orally bioavailable. For this reason, apixaban belongs to the direct oral anticoagulants (DOACs). Apixaban does not inhibit thrombin.
Clinical significance
The following applications are indicated: Prophylaxis of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation and one or more risk factors, such as congestive heart failure, hypertension, age above 75 years, diabetes mellitus, stroke or transient ischemic attack; Treatment of deep vein thrombosis and pulmonary embolism as well as prophylaxis of recurrent deep vein thrombosis and pulmonary embolism.
Indication
- Routine monitoring is not necessary.
- For complications and risk groups, an anti-factor Xa activity test is recommended, which should be calibrated and controlled with apixaban.
Literature
- Schmitz EM, Boonen K, van den Heuvel DJ, van Dongen JL, Schellings MW, Emmen JM, van der Graaf F, Brunsveld L, van de Kerkhof D Determination of dabigatran, rivaroxaban and apixaban by ultra-performance liquid chromatography - tandem mass spectrometry (UPLC-MS/MS) and coagulation assays for therapy monitoring of novel direct oral anticoagulants. J Thromb Haemost. Oct12(10):1636-46, 2006.
- Keating GM. Apixaban: a review of its use for reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Drugs. 73(8):825-43, 2013.