Apixaban is a novel oral anticoagulant belonging to the class of direct Factor Xa inhibitors. It is primarily used for the prevention and treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and for reducing the risk of stroke in patients with atrial fibrillation. This medication inhibits the activity of Factor Xa in the coagulation cascade, effectively reducing thrombus formation while decreasing dietary restrictions and monitoring frequency associated with traditional warfarin therapy.
Compared to traditional anticoagulants, apixaban offers advantages such as fixed dosing and no food interactions, but it must be used strictly according to medical instructions to avoid serious side effects like bleeding.
Brand Name: Eliquis
Generic Name: Apixaban
This medication is marketed under the brand name Eliquis in Taiwan and Hong Kong and is a prescription drug requiring a physician’s prescription.
Apixaban is classified as a "Direct Oral Anticoagulant" (DOAC), specifically targeting Factor Xa, which inhibits the conversion of prothrombin to thrombin, thereby preventing clot expansion.
This class of drugs differs from traditional anticoagulants like warfarin in mechanism, with rapid onset and a shorter half-life, but interactions with other medications must be carefully considered.
Physicians may adjust dosages based on patient age and renal function; for example, patients with severe kidney disease may require reduced doses to prevent excessive anticoagulation.
Mild side effects include:
Serious side effects requiring immediate medical attention include:
Contraindications:
Pregnancy is classified as Category C; use only if necessary. Patients should inform their healthcare provider before surgery to evaluate the timing of discontinuation. Elderly patients require close monitoring for bleeding risks.
Concurrent use with the following drugs may increase bleeding risk:
Avoid combining with potent CYP3A4 inducers (e.g., carbamazepine), which may reduce efficacy. Consult a healthcare provider before using herbal supplements or other medications.
Dosage varies according to condition:
Take the medication whole; do not chew. It can be taken with or without food. In case of overdose, seek immediate medical attention; there is no specific antidote available currently.
If a dose is missed and more than 6 hours remain before the next dose, take it immediately and then resume the regular schedule. If it is close to the next dose, skip the missed dose and do not double the dose.
Do not delay treatment due to missed doses; establish a fixed medication reminder system, such as alarms or pillboxes.
Overdose may cause subcutaneous bruising, hematuria, or hematemesis, requiring urgent medical attention. Emergency measures include monitoring coagulation function, blood transfusion, or administering specific coagulation factor concentrates.
Emergency: If symptoms such as confusion, severe headache, or unexplained bleeding occur, go to the emergency room immediately; do not attempt self-treatment.
Apixaban can be taken with or without food, but it is recommended to take it at the same time daily to maintain stable drug levels. Avoid taking it with high-fat meals, as this may increase absorption variability. There is no need to completely avoid specific foods, but excessive intake of grapefruit or grapefruit juice (more than 1 liter daily) may affect drug pharmacokinetics.
What should I do if I notice minor bleeding signs (such as gum bleeding) while on medication?Minor bleeding like gum bleeding or nosebleeds can be managed by applying pressure and cold compresses. If bleeding persists over 10 minutes or occurs frequently, contact your healthcare provider for assessment and possible dose adjustment. Bleeding is a common side effect of anticoagulants but should be monitored for accompanying symptoms like headache or abdominal pain.
What interactions should I be aware of when using other anticoagulants?Using apixaban with warfarin, heparin, or other anticoagulants may increase bleeding risk and is generally not recommended. When combined with NSAIDs like ibuprofen, dose adjustments should be made under medical supervision. When used with drugs affecting P-glycoprotein (e.g., quinidine), coagulation parameters should be monitored.
Should I stop medication before dental procedures or minor surgeries?For invasive procedures such as tooth extraction or endoscopy, consult your doctor 3 to 5 days in advance to determine whether to temporarily discontinue medication. The physician will evaluate the bleeding risk versus thrombosis risk and may recommend bridging anticoagulation therapy if necessary.
Is routine blood monitoring required for long-term use?Unlike warfarin, apixaban generally does not require regular INR monitoring. However, if the patient has liver or kidney dysfunction or shows signs of severe bleeding, the doctor may order coagulation tests such as aPTT or renal function tests. It is advisable to inform your healthcare provider about any changes or reactions during follow-up visits every 3 to 6 months.
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