What class of anticoagulant medications is Eliquis (apixaban) considered to be?

Eliquis Drug Classification

Eliquis (apixaban) is a direct oral anticoagulant (DOAC), specifically a direct factor Xa inhibitor. 1

Primary Classification

• Eliquis belongs to the class of direct oral anticoagulants (DOACs), which is the recommended nomenclature established by the International Society on Thrombosis and Haemostasis (ISTH) 1
• The term "DOAC" is preferred over older terminology such as "novel oral anticoagulants (NOACs)" or "non-vitamin K antagonist oral anticoagulants" 1

Specific Mechanism of Action

• Apixaban is specifically classified as a direct factor Xa (FXa) inhibitor, distinguishing it from direct thrombin inhibitors like dabigatran 1
• It works by directly and selectively inhibiting factor Xa, blocking both free factor Xa and clot-bound factor Xa activity 2, 3, 4
• This mechanism differs fundamentally from vitamin K antagonists (like warfarin), which work through multiple coagulation factors 1

Clinical Context

• DOACs as a class represent the current standard of care for prevention and treatment of common thrombotic disorders including atrial fibrillation and venous thromboembolism 1
• The DOAC class includes apixaban (Eliquis), rivaroxaban (Xarelto), edoxaban (Lixiana), and dabigatran (Pradaxa) 1
• When clinically relevant to distinguish between DOACs, the specific mechanism should be stated: apixaban is an "oral direct factor Xa inhibitor" 1

Important Nomenclature Note

• The abbreviation "NOAC" should be avoided as it can be misinterpreted to mean "no anticoagulation" and the drugs are no longer "novel" 1
• The 2023 ISTH guidance recommends describing anticoagulants by route of administration and specific target (e.g., "oral factor Xa inhibitor") 1