From the Guidelines
The standard Eliquis (apixaban) dosing for DVT treatment begins with 10 mg taken orally twice daily for the first 7 days, followed by 5 mg twice daily. According to the 2020 ACC expert consensus decision pathway for anticoagulant and antiplatelet therapy in patients with atrial fibrillation or venous thromboembolism undergoing percutaneous coronary intervention or with atherosclerotic cardiovascular disease 1, this dosing regimen is recommended for the treatment of Venous Thromboembolism (VTE).
Some key points to consider when using apixaban for DVT treatment include:
- The initial 7-day treatment period with 10 mg twice daily is crucial for effective treatment
- After the initial 7-day period, the dose is reduced to 5 mg twice daily
- Dose adjustments may be necessary for certain patients, such as those with severe renal impairment or hepatic impairment
- It is essential to take Eliquis at the same times each day with or without food and never skip doses to minimize the risk of bleeding complications
The European Heart Journal study from 2014 2 compared apixaban with conventional therapy in patients with acute VTE and found that apixaban was non-inferior to conventional therapy for the primary efficacy outcome and had a lower risk of major bleeding. However, the most recent and highest-quality study, the 2020 ACC expert consensus decision pathway 1, provides the most up-to-date guidance on apixaban dosing for DVT treatment.
In terms of specific dose adjustments, patients with at least two of the following: age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL, may require a dose reduction to 2.5 mg twice daily after the initial 7-day treatment period. Additionally, patients with severe renal impairment (creatinine clearance 15-29 mL/min) should receive 2.5 mg twice daily after the initial treatment phase. It is crucial to carefully monitor patients with hepatic impairment and consider dose adjustments or alternative treatments for those with moderate to severe liver disease.
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 3
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 4.
- 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) 4.
- 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 5.
- 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 6.