From the Guidelines
The half-life of apixaban is approximately 12 hours in most patients with normal renal function. This means that after 12 hours, about half of the drug has been eliminated from the body. Apixaban, a direct oral anticoagulant (DOAC), is primarily metabolized by the liver and eliminated through multiple pathways, with about 27% cleared by the kidneys 1. The half-life can be prolonged in elderly patients, those with renal impairment (particularly when creatinine clearance is below 30 mL/min), or in patients with hepatic dysfunction.
Key Points to Consider
- The half-life of apixaban is an important consideration for managing bleeding events and planning surgical procedures, as complete drug clearance typically takes 2-3 days (about 5 half-lives) in patients with normal organ function.
- Apixaban requires twice-daily dosing for most indications due to its relatively short half-life compared to warfarin (which has a half-life of 20-60 hours) 1.
- The predictable pharmacokinetics of apixaban allows for fixed dosing without routine coagulation monitoring.
- Renal dosing adjustments are necessary for patients with severe renal impairment, with a recommended dose of 2.5 mg twice daily if any two of the following conditions are met: age ≥80 years, serum creatinine ≥1.5 mg/dL, or body weight ≤60 kg 1.
Clinical Implications
- Clinicians should be aware of the half-life of apixaban when managing patients on this medication, particularly in the context of surgical procedures or bleeding events.
- The half-life of apixaban can be influenced by various factors, including renal function, age, and hepatic function, which should be taken into account when prescribing this medication.
From the FDA Drug Label
Apixaban has a total clearance of approximately 3. 3 L/hour and an apparent half-life of approximately 12 hours following oral administration.
The half-life of apixaban (Eliquis) is approximately 12 hours 2.
From the Research
Half-Life of Apixaban
- The half-life of apixaban is approximately 12 hours 3, 4
- This means that it takes around 12 hours for the concentration of apixaban in the blood to reduce by half 3
- The elimination of apixaban occurs via multiple pathways, including metabolism, biliary excretion, and direct intestinal excretion, with approximately 27% of total apixaban clearance occurring via renal excretion 3
- The pharmacokinetics of apixaban are consistent across a broad range of patients, and apixaban has limited clinically relevant interactions with most commonly prescribed medications 3
Pharmacokinetic Properties
- Apixaban is rapidly absorbed, with maximum concentration occurring 3-4 hours after oral administration 3
- The absolute oral bioavailability of apixaban is approximately 50% 3
- Food does not have a clinically meaningful impact on the bioavailability of apixaban 3
- Apixaban exposure increases dose proportionally for oral doses up to 10 mg 3