From the Guidelines
Eliquis (apixaban) is a recommended treatment for deep vein thrombosis (DVT), with a standard dosing regimen of 10 mg taken orally twice daily for the first 7 days, followed by 5 mg twice daily for at least 3 months. This recommendation is based on the most recent and highest quality study available, which suggests that apixaban is non-inferior to conventional therapy for the treatment of DVT, with a lower risk of major bleeding 1. The American Society of Hematology 2020 guidelines for management of venous thromboembolism also support the use of apixaban for the treatment of DVT, with a conditional recommendation for the use of either the standard dose or a lower dose of apixaban for secondary prevention of recurrent VTE 1.
Key Considerations
- Apixaban works by inhibiting Factor Xa, a key component in the blood clotting process, thereby preventing clot formation and growth.
- It does not require routine blood monitoring like warfarin does, making it more convenient for patients.
- However, apixaban should be taken with caution in patients with severe kidney disease, and dose adjustments may be necessary for elderly patients or those with certain medical conditions.
- Common side effects include increased risk of bleeding, bruising, and nausea.
- Patients should avoid taking apixaban with other blood thinners unless specifically directed by their doctor, and should inform all healthcare providers about taking this medication before any procedures.
Dosing Regimen
- The standard dosing regimen for DVT treatment is 10 mg taken orally twice daily for the first 7 days, followed by 5 mg twice daily for at least 3 months.
- For DVT prevention after hip or knee replacement surgery, the dose is typically 2.5 mg twice daily.
- The use of a lower dose of apixaban (2.5 mg twice daily) may be considered for secondary prevention of recurrent VTE, but this should be individualized based on the patient's risk of recurrence and bleeding 1.
From the FDA Drug Label
1.3 Treatment of Deep Vein Thrombosis Apixaban tablets are indicated for the treatment of DVT.
2.1 Recommended Dose Treatment of DVT and PE The recommended dose of apixaban tablets 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.
Eliquis (apixaban) is indicated for the treatment of Deep Vein Thrombosis (DVT). The recommended dose for DVT treatment is 10 mg twice daily for the first 7 days, followed by 5 mg twice daily 2.
From the Research
Eloquis for DVT
- Eloquis, also known as apixaban, is an oral factor Xa inhibitor used for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) 3, 4.
- Apixaban has a rapid onset of action and predictable pharmacokinetics, allowing for a fixed dose regimen and eliminating the need for initial parenteral anticoagulant therapy and laboratory monitoring 3.
- The fixed-dose regimen of oral apixaban alone is as effective as conventional treatment regimens and is associated with a clinically relevant reduction of major bleeding 3.
- Extended anticoagulation with apixaban reduces the risk of recurrent venous thromboembolism without increasing the rate of major bleeding 3, 4.
Advantages of Apixaban
- Apixaban offers several advantages over historical therapy for the treatment and secondary prevention of VTE, including a simpler treatment regimen and reduced risk of major bleeding 4.
- Apixaban is a reasonable alternative to standard therapy for the treatment of DVT and PE, and as extended thromboprophylaxis 5, 6.
Special Populations
- There are some populations in which the use of apixaban has not been extensively studied, such as patients over 75 years old, or those with cancer, low or high body weight, or poor renal function 4.
- Additional studies are needed to assess the efficacy and safety of apixaban in these special populations, including the elderly, obese, and those with renal impairment and cancer-associated DVT 4, 7.