From the Guidelines
The recommended dose of Apixaban (Eliquis) for Deep Vein Thrombosis (DVT) is 10 mg orally twice daily for the first 7 days, followed by 5 mg orally twice daily. This dosing regimen is based on the most recent and highest quality evidence available, as outlined in 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.
Key points to consider when prescribing Apixaban for DVT include:
- The medication should be taken with or without food at approximately the same times each day to maintain consistent blood levels.
- For DVT prevention after initial treatment, a reduced dose of 2.5 mg twice daily may be prescribed for extended therapy.
- Dose adjustments are necessary for patients with certain criteria: age ≥80 years, body weight ≤60 kg, or serum creatinine ≥1.5 mg/dL.
- Apixaban works by inhibiting Factor Xa, preventing blood clot formation without requiring routine blood monitoring like warfarin.
- Patients should avoid stopping Apixaban suddenly without medical guidance due to increased stroke risk, and should inform all healthcare providers about taking this blood thinner before any procedures.
- Bleeding is the primary side effect to watch for, and patients should seek immediate medical attention for unusual bleeding or bruising.
It's worth noting that the evidence from other studies, such as the AMPLIFY trial 1, also supports the use of Apixaban for DVT treatment, but the most recent and highest quality evidence is from the 2020 ACC expert consensus decision pathway 1. Additionally, other studies have evaluated the use of Apixaban in different patient populations, such as those with cancer 1, but the recommended dose remains the same. Overall, the use of Apixaban for DVT treatment is supported by a strong evidence base, and the recommended dose is effective in preventing recurrent VTE while minimizing the risk of major bleeding.
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. The dose of Apixaban (Elquis) for Deep Vein Thrombosis (DVT) is:
- 10 mg twice daily for the first 7 days
- 5 mg twice daily after 7 days 2
From the Research
Apixaban Dosing for Deep Vein Thrombosis (DVT)
- The dose of Apixaban (Elquis) for Deep Vein Thrombosis (DVT) is typically 10 mg twice daily for the first 7 days, followed by 5 mg twice daily 3.
- This dosing regimen is used for the treatment of venous thromboembolism, including DVT and pulmonary embolism 4, 3.
- Extended anticoagulation with Apixaban can be done with either a treatment dose (5 mg twice daily) or a thromboprophylactic dose (2.5 mg twice daily) to reduce the risk of recurrent venous thromboembolism without increasing the rate of major bleeding 4, 5.
Special Considerations
- In patients with cancer-associated venous thromboembolism, Apixaban can be used at a dose of 10 mg twice daily for the first 7 days, followed by 5 mg twice daily, and is noninferior to subcutaneous dalteparin for the treatment of cancer-associated venous thromboembolism without an increased risk of major bleeding 3.
- The API-CAT study is investigating whether a reduced-dose regimen of Apixaban (2.5 mg twice daily) is noninferior to a full-dose regimen (5 mg twice daily) for the prevention of recurrent VTE in patients with active cancer 5.