What is the initial therapy dosage of Eliquis (apixbarin) for Deep Vein Thrombosis (DVT)?

From the Guidelines

For deep vein thrombosis (DVT) treatment, Eliquis (apixaban) is typically started with a loading dose of 10 mg twice daily for the first 7 days, followed by 5 mg twice daily for at least 3 months. This recommendation is based on the most recent and highest quality study available, which is the NCCN guidelines insights: cancer-associated venous thromboembolic disease, version 2.2018 1. The study provides dosing details for apixaban, which is consistent with the recommended initial therapy dosage for DVT.

Key Considerations

• The initial loading dose of 10 mg twice daily for 7 days helps to quickly achieve therapeutic levels of apixaban in the body.
• After the loading dose, the maintenance dose of 5 mg twice daily is used to prevent further clot formation and reduce the risk of recurrent VTE.
• It's essential to take Eliquis with or without food at approximately the same times each day to maintain consistent blood levels, as food can affect the absorption of the medication.
• Patients with reduced kidney function or those who weigh less than 60 kg may require dose adjustments, which should be made under the guidance of a healthcare provider.

Monitoring and Follow-up

• Regular follow-up appointments are necessary to monitor the patient's response to treatment and determine the appropriate duration of therapy based on their specific risk factors and circumstances.
• Patients should be educated on the signs of bleeding, such as unusual bruising, nosebleeds, or blood in urine or stool, and instructed to seek medical attention immediately if they experience any of these symptoms.
• The NCCN guidelines also emphasize the importance of avoiding other blood thinners unless specifically prescribed together, as this can increase the risk of bleeding complications 1.

Evidence Summary

The NCCN guidelines provide a comprehensive overview of the management of VTE, including the use of apixaban for DVT treatment 1. The guidelines are based on the latest available evidence and provide recommendations for dosing, monitoring, and follow-up care. In contrast, the 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism provide information on the use of apixaban in the treatment of VTE, but the dosing recommendations are not as specific as those provided in the NCCN guidelines 1. Therefore, the NCCN guidelines are considered the highest quality evidence for this question.

From the FDA Drug Label

The recommended dose of apixaban tablets 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 initial therapy dosage of Eliquis (apixaban) for Deep Vein Thrombosis (DVT) is 10 mg twice daily for the first 7 days. 2

From the Research

Initial Therapy Dosage of Eliquis (Apixbarin) for Deep Vein Thrombosis (DVT)

• The initial therapy dosage of Eliquis (apixaban) for DVT is not explicitly stated in the provided studies 3, 4, 5.
• However, according to the study published in 2018 6, apixaban is an oral factor Xa inhibitor with a rapid onset of action and predictable pharmacokinetics that allows a fixed dose regimen.
• The study mentions that the fixed-dose regimen of oral apixaban alone is as effective as conventional treatment regimen and is associated with a clinically relevant reduction of major bleeding 6.
• The treatment dose of apixaban is mentioned as 5 mg twice daily, and the thrombopropholic dose is mentioned as 2.5 mg twice daily 6.
• Another study published in 2016 7 compares direct oral anticoagulants (DOACs), including apixaban, with standard therapy in the treatment of deep vein thrombosis and/or pulmonary embolism and in the secondary prevention of recurrent venous thromboembolism.
• The study mentions that rivaroxaban and apixaban were tested as a single-drug approach, whereas in the dabigatran and edoxaban studies, initial bridging with parenteral agents was employed 7.

Key Points

• Apixaban is an oral factor Xa inhibitor with a rapid onset of action and predictable pharmacokinetics 6.
• The fixed-dose regimen of oral apixaban alone is as effective as conventional treatment regimen and is associated with a clinically relevant reduction of major bleeding 6.
• The treatment dose of apixaban is 5 mg twice daily, and the thrombopropholic dose is 2.5 mg twice daily 6.