What are the dose adjustments for Apixaban (Eliquis) in the treatment of Deep Vein Thrombosis (DVT)?

From the Guidelines

The standard Eliquis (apixaban) dosing for deep vein thrombosis (DVT) treatment begins with 10 mg taken orally twice daily for the first 7 days, followed by 5 mg twice daily. This dosing regimen is based on the most recent and highest quality study, which provides a clear guideline for the treatment of VTE, including DVT 1. The study outlines the anticoagulation dosing table for VTE, which includes apixaban as a recommended treatment option.

Key Considerations for Dose Adjustments

• The dose adjustments for apixaban are crucial to ensure effective anticoagulation while minimizing bleeding risks.
• Patients with certain characteristics, such as age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL, may require dose adjustments.
• However, the provided evidence does not specify the exact dose adjustments for these patient populations, and therefore, the standard dosing regimen should be followed unless otherwise specified by a healthcare provider.
• It is essential to note that apixaban should be taken with water, with or without food, at approximately the same times each day to maintain consistent blood levels.
• If a dose is missed, it should be taken as soon as remembered, and then continue with twice-daily dosing.

Comparison with Other Studies

• The 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism provide additional information on the treatment of VTE, including the use of apixaban 1.
• However, the most recent and highest quality study, which is the 2021 ACC expert consensus decision pathway, should be prioritized when making treatment decisions 1.
• The study provides a clear and concise guideline for the treatment of VTE, including DVT, and outlines the recommended dosing regimen for apixaban.

Clinical Implications

• The standard dosing regimen for apixaban should be followed for the treatment of DVT, unless otherwise specified by a healthcare provider.
• Healthcare providers should be aware of the potential need for dose adjustments in certain patient populations and monitor patients closely for bleeding risks and other adverse effects.
• The use of apixaban for the treatment of DVT has been shown to be effective and safe, with a lower risk of major bleeding compared to conventional therapy 1.

From the FDA Drug Label

The recommended dose of apixaban tablets for the treatment of DVT 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.

Dose Adjustments for Apixaban (Eliquis) in DVT Treatment:

• Initial dose: 10 mg orally twice daily for 7 days
• Maintenance dose: 5 mg orally twice daily after 7 days 2

From the Research

Dose Adjustments for Apixaban in DVT Treatment

• The standard treatment dose of apixaban for Deep Vein Thrombosis (DVT) is 5 mg twice daily 3.
• For extended anticoagulation, apixaban can be used at either the treatment dose (5 mg twice daily) or the thromboprophylactic dose (2.5 mg twice daily) 3.
• In some cases, such as upper extremity DVT, apixaban may be initiated at a dose of 10 mg PO twice daily for 7 days, followed by 5 mg twice daily for 11 weeks 4.
• For patients with persistent thrombotic risk factors or without recanalization of the DVT, a low-dose of apixaban (2.5 mg twice daily) may be considered for extended anticoagulation 5.

Special Considerations

• The dose of apixaban may need to be adjusted based on the patient's renal function and other individual factors 3, 5.
• The use of apixaban for DVT treatment has been shown to be effective and safe, with a reduced risk of major bleeding compared to traditional anticoagulant therapy 3, 4, 5.