From the Guidelines
The recommended starting dosage of Eliquis (apixaban) for confirmed deep vein thrombosis (DVT) is 10 mg taken orally twice daily for the first 7 days, followed by 5 mg twice daily thereafter. This dosage is appropriate for a patient weighing 143 pounds, as Eliquis dosing for DVT treatment is not weight-based within the normal adult weight range. The initial higher dose helps establish therapeutic anticoagulation quickly to prevent clot progression, while the maintenance dose provides ongoing protection against recurrent thrombosis.
Key Considerations
- The medication should be taken with or without food at approximately 12-hour intervals.
- Patients should be advised to avoid missing doses, as consistent blood levels are important for effective anticoagulation.
- Renal function should be assessed before starting therapy, as dose adjustments may be needed for patients with severe renal impairment, as noted in the study by 1.
- Patients should also be informed about potential bleeding risks and advised to report any unusual bleeding or bruising to their healthcare provider.
Evidence-Based Recommendation
The recommended dosage is based on the study by 1, which provides the most recent and highest quality evidence for the treatment of DVT with apixaban. The American Society of Hematology 2020 guidelines also support the use of apixaban for the treatment of DVT, as mentioned in the study by 1. However, the study by 1 provides more specific guidance on the dosing regimen for apixaban in patients with DVT.
Patient-Specific Factors
- Patient weight: 143 pounds, which is within the normal adult weight range and does not require dose adjustment.
- Renal function: should be assessed before starting therapy to determine if dose adjustments are needed.
- Bleeding risk: patients should be informed about the potential bleeding risks and advised to report any unusual bleeding or bruising to their healthcare provider.
From the FDA Drug Label
- DOSAGE & ADMINISTRATION The recommended dose of apixaban tablets for the treatment of DVT and PE 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 recommended starting dosage of Eliquis (apixaban) for confirmed Deep Vein Thrombosis (DVT) is 10 mg taken orally twice daily for the first 7 days of therapy. There is no dosage adjustment based on weight in the provided label for the treatment of DVT, so the patient's weight of 143 pounds does not affect the recommended starting dose 2.
From the Research
Recommended Starting Dosage of Eliquis (Apixaban) for Confirmed Deep Vein Thrombosis (DVT)
- The recommended starting dosage of Eliquis (apixaban) for confirmed Deep Vein Thrombosis (DVT) is 10 mg twice daily for 7 days, followed by 5 mg twice daily 3, 4.
- This dosage regimen is applicable to patients with DVT, regardless of their weight, including a patient weighing 143 pounds 3, 4.
- The dosage adjustment criteria (DAC) for non-valvular atrial fibrillation (NVAF) include age, body weight, and renal function, but these criteria do not apply to DVT treatment 3.
- Studies have shown that apixaban is effective and safe for the treatment of DVT, with a fixed-dose regimen that eliminates the need for initial parenteral anticoagulant therapy and laboratory monitoring 5, 4.
Considerations for Apixaban Treatment
- Apixaban has a rapid onset of action and predictable pharmacokinetics, allowing for a fixed-dose regimen 5.
- The treatment dose of apixaban (5 mg twice daily) or thromboprophylactic dose (2.5 mg twice daily) can be used for extended anticoagulation, reducing the risk of recurrent venous thromboembolism without increasing the rate of major bleeding 5.
- Coagulation markers, such as anti-factor Xa activity, prothrombin time, and activated partial thromboplastin time, may differ in patients with DVT prescribed higher doses of apixaban, and a dosage adjustment criteria (DAC) may be warranted in such patients 3.