From the Guidelines
Eliquis (apixaban) should not be taken once daily for Deep Vein Thrombosis (DVT) prevention, as its standard dosing is twice daily to maintain adequate blood levels and prevent blood clots. The standard dosing for Eliquis in DVT prevention is twice daily, with a recommended dose of 2.5 mg taken twice daily for patients undergoing hip or knee replacement surgery, and 10 mg twice daily for 7 days, followed by 5 mg twice daily for treatment of DVT or prevention of recurrent DVT 1.
Key Points to Consider
- Taking Eliquis only once a day would likely not maintain adequate blood levels of the medication throughout a 24-hour period, potentially reducing its effectiveness in preventing blood clots.
- Eliquis works by inhibiting Factor Xa, a key component in the blood clotting process, and its pharmacokinetic profile is designed for twice-daily administration to maintain consistent anticoagulation.
- While there is some evidence that lower doses of apixaban (2.5 mg twice daily) may be effective for secondary prevention of recurrent VTE, this is not the same as once-daily dosing, and the standard dose is still recommended for most patients 1.
- If you're concerned about medication frequency, it's essential to discuss with your healthcare provider, as other anticoagulants like Xarelto (rivaroxaban) are approved for once-daily dosing in certain situations.
Important Considerations
- The American Society of Hematology 2020 guidelines for management of venous thromboembolism recommend that the standard dose or the lower dose of rivaroxaban or apixaban may be used for the secondary prevention of VTE, but this does not imply once-daily dosing 1.
- Additional research is necessary to identify which subsets of patients who are going to continue anticoagulant therapy indefinitely for secondary prevention can safely use a lower-dose DOAC and which patients should be maintained on a standard dose.
From the Research
Eliquis (Apixaban) and Deep Vein Thrombosis (DVT) Prevention
- The provided studies do not directly address whether Eliquis (apixaban) once daily prevents Deep Vein Thrombosis (DVT) 2, 3, 4, 5, 6.
- However, study 5 mentions that apixaban is effective for stroke prevention in atrial fibrillation and has advantages over warfarin, but does not provide strong evidence that it should replace warfarin or low-molecular-weight heparin (LMWH) in primary prevention, treatment, or secondary prevention of VTE.
- Study 6 investigates the effectiveness of intermittent pneumatic compression (IPC) devices combined with anticoagulants (rivaroxaban) for the prevention of DVT after total knee arthroplasty, but does not specifically address apixaban.
- Study 3 discusses the efficacy of pharmacological prophylaxis, including low-dose unfractionated heparin, low molecular weight heparin, fondaparinux, and warfarin, in preventing VTE in at-risk hospitalized patients, but does not mention apixaban specifically.
- Study 2 evaluates the safety and efficacy of fondaparinux in preventing VTE in high-risk trauma patients, and study 4 examines the impact of removing graduated compression stockings on the incidence of pressure injuries and DVT in patients on a gastrointestinal sarcoma surgery unit, but neither study addresses apixaban.
Available Evidence on Apixaban
- The available evidence suggests that apixaban is effective for stroke prevention in atrial fibrillation, but its role in preventing DVT is not clearly established in the provided studies 5.
- Further research is needed to determine the efficacy of apixaban in preventing DVT, particularly in comparison to other anticoagulants and mechanical prophylaxis methods 5, 6.