From the Guidelines
For deep vein thrombosis (DVT) treatment, Eliquis (apixaban) is typically prescribed at a dose of 10 mg taken orally 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 2020 American Society of Hematology guidelines for management of venous thromboembolism 1. Although this study does not directly address the initial therapy dosage, it provides guidance on the use of direct oral anticoagulants (DOACs) for the treatment of DVT. The initial dose of 10 mg twice daily for 7 days is supported by earlier studies, such as the 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism 1, which demonstrated the efficacy and safety of apixaban in patients with acute venous thromboembolism.
Key Considerations
- The higher initial dose of 10 mg twice daily helps establish therapeutic anticoagulation quickly to address the acute clot.
- Eliquis should be taken with or without food at approximately 12-hour intervals to maintain consistent blood levels.
- Patients should inform all healthcare providers about taking Eliquis before any procedures and should not stop taking it without medical guidance.
- Common side effects include increased bleeding risk, so unusual bleeding or bruising should be reported immediately.
- Patients should also avoid other blood thinners unless specifically directed by their doctor.
Mechanism of Action
Eliquis works by inhibiting Factor Xa, a key component in the blood clotting process, thereby preventing existing clots from growing and new clots from forming while the body naturally dissolves the existing clot. This mechanism of action is supported by the 2014 ESC guidelines, which demonstrated the efficacy of apixaban in preventing recurrent symptomatic venous thromboembolism or death related to venous thromboembolism 1.
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. Treatment of DVT and PE 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 taken orally twice daily for the first 7 days of therapy 2.
From the Research
Initial Therapy Dosage of Eliquis (Apixaban) for Deep Vein Thrombosis (DVT)
- The initial therapy dosage of Eliquis (apixaban) for DVT is not explicitly stated in the provided studies as an initial dose, but the treatment dose is mentioned as 5 mg twice daily 3.
- Apixaban is an oral factor Xa inhibitor with a rapid onset of action and predictable pharmacokinetics that allows a fixed dose regimen, which simplifies treatment of VTE and eliminates the need for initial parenteral anticoagulant therapy and laboratory monitoring 3.
- Extended anticoagulation with apixaban with either a treatment dose (5 mg twice daily) or thromboprophylactic dose (2.5 mg twice daily) reduces the risk of recurrent venous thromboembolism without increase in the rate of major bleeding 3.
- Non-Vitamin K antagonists oral anticoagulants (NOACs), including apixaban, are considered as first-line therapy in the anticoagulation therapy for DVT and are recommended as the preferred anticoagulant agents by most scientific societies 4.
- The direct oral anticoagulants (DOACs), including apixaban, have been compared with standard therapy in large phase III studies to assess their safety and efficacy in the treatment of deep vein thrombosis and/or pulmonary embolism and in the secondary prevention of recurrent venous thromboembolism 5.