From the Guidelines
For acute pulmonary embolism (PE), Eliquis (apixaban) is typically dosed at 10 mg twice daily for the first 7 days, followed by 5 mg twice daily for at least 3 months. This dosing regimen is based on the 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism 1. The guidelines suggest that apixaban, a direct factor Xa inhibitor, is non-inferior to conventional therapy (enoxaparin/warfarin) in patients with acute VTE, including those with PE. The study found that apixaban was associated with a lower risk of major bleeding compared to conventional therapy (RR 0.31; 95% CI 0.17–0.55; P < 0.001 for superiority) 1.
Key considerations for Eliquis dosing in acute PE include:
- Initial dose: 10 mg twice daily for 7 days
- Maintenance dose: 5 mg twice daily for at least 3 months
- Dose adjustments: necessary for patients with certain criteria, such as age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL, who should receive 2.5 mg twice daily after the initial 7-day treatment period
- Renal function assessment: necessary before starting therapy, as severe renal impairment (CrCl <15 mL/min) is a contraindication
- Patient counseling: important for bleeding risks, medication adherence, and potential drug interactions 1.
It is essential to note that the evidence supports the use of apixaban as an alternative to standard treatment for acute PE, with a favorable safety profile compared to conventional therapy 1.
From the FDA Drug Label
The recommended dose of apixaban tablets for the treatment of DVT and PE 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. The recommended dose of apixaban (Eliquis) for acute PE is:
- 10 mg taken orally twice daily for the first 7 days of therapy
- 5 mg taken orally twice daily after 7 days 2
From the Research
Eliquis Dosing for Acute PE
- The dosing for Eliquis (apixaban) in the treatment of acute pulmonary embolism (PE) is not explicitly stated in the provided studies.
- However, according to the study 3, direct oral anticoagulants such as apixaban are recommended as first-line therapy for patients with PE and a systolic blood pressure of 90 mm Hg or higher.
- The study 4 provides an overview of apixaban in the treatment of venous thromboembolism, including PE, but does not specify the dosing for acute PE.
- The studies 5, 6, and 7 discuss the diagnosis and treatment of acute PE, including the use of anticoagulants and interventional strategies, but do not provide specific information on Eliquis dosing.
Treatment of Acute PE
- The treatment of acute PE typically involves anticoagulation, with direct oral anticoagulants such as apixaban being a recommended option 3.
- Systemic thrombolysis is recommended for patients with high-risk PE, and catheter-based treatments may be considered for intermediate- and high-risk patients 5, 7.
- The choice of treatment depends on the patient's risk profile and individual characteristics, and may involve a multidisciplinary approach 7.