From the Guidelines
Eliquis (apixaban) should be dosed at 5 mg twice daily for most patients, but a reduced dose of 2.5 mg twice daily is recommended for patients who meet at least two of the following criteria: age ≥80 years, body weight ≤60 kg, or serum creatinine ≥133 mmol/L, as per the 2024 ESC guidelines for the management of atrial fibrillation 1. The dosing of Eliquis is crucial in preventing thromboembolic events while minimizing the risk of bleeding complications.
- The standard full dose of 5 mg twice daily is recommended for most patients.
- A reduced dose of 2.5 mg twice daily is recommended for patients who meet at least two of the following criteria:
- age ≥80 years
- body weight ≤60 kg
- serum creatinine ≥133 mmol/L This is in line with the recommendations from the 2024 ESC guidelines for the management of atrial fibrillation, which prioritizes the prevention of thromboembolic events while considering the risk of bleeding complications 1. The 2023 ACC/AHA/ACC/HRS guideline for the diagnosis and management of atrial fibrillation also supports this dosing strategy, highlighting the importance of considering renal function and other factors when determining the appropriate dose of Eliquis 1. In contrast, the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation provides additional context on the use of Eliquis, but the more recent guidelines take precedence in guiding clinical practice 1. Overall, the dosing of Eliquis should be individualized based on patient-specific factors, and healthcare providers should consult the most recent guidelines and clinical evidence to ensure optimal patient outcomes.
From the FDA Drug Label
The recommended dose of apixaban tablets for most patients is 5 mg taken orally twice daily. The recommended dose of apixaban tablets is 2.5 mg twice daily in patients with at least two of the following characteristics: • age greater than or equal to 80 years • body weight less than or equal to 60 kg • serum creatinine greater than or equal to 1.5 mg/dL
The low dose of Eliquis (apixaban) is 2.5 mg twice daily, which is recommended for patients with certain characteristics, including age greater than or equal to 80 years, body weight less than or equal to 60 kg, or serum creatinine greater than or equal to 1.5 mg/dL 2.
From the Research
Eliquis (Apixaban) Guidelines
- The dosage of Eliquis (apixaban) is typically 5 mg twice daily for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation 3.
- However, for patients with at least two of the following characteristics: age 80 years or older, weight 60 kg or less, or serum creatinine 1.5 mg/dL or greater, the recommended dose is 2.5 mg twice daily 4.
- The selection of the dosage regimen may influence drug choice, and once-daily versus twice-daily regimens have practical implications, such as the impact of missing a dose on anticoagulation 5.
- Some studies have found that a once-daily dosing regimen leads to better adherence and persistence to therapy, which is an important consideration for maintaining optimum anticoagulation 5.
- Apixaban has been shown to be effective and safe for the treatment of venous thromboembolism, with a fixed-dose regimen that eliminates the need for initial parenteral anticoagulant therapy and laboratory monitoring 6.
- The efficacy and safety of apixaban have been compared to other direct oral anticoagulants, such as dabigatran and rivaroxaban, with apixaban being associated with a lower risk of major bleeding in some studies 3.
- The clinical and pharmacological effects of apixaban dose adjustment have been studied, with results showing that the effects of apixaban dose adjustment to 2.5 mg twice daily versus warfarin were consistent for coagulation biomarkers and clinical outcomes 4.