Is Eliquis (apixaban) used to target factor V or treat factor V deficiency/Leiden?

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Last updated: February 8, 2026 • View editorial policy

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Eliquis (Apixaban) Mechanism of Action

No, Eliquis (apixaban) is NOT for Factor V—it is a direct Factor Xa (Factor 10) inhibitor and has no role in treating Factor V Leiden or Factor V deficiency. 1

What Apixaban Actually Targets

Apixaban is a highly selective, reversible direct Factor Xa inhibitor that works by blocking activated Factor X in the coagulation cascade. 2, 3 Specifically:

  • Apixaban inhibits both free Factor Xa and clot-bound Factor Xa, preventing the conversion of prothrombin to thrombin 4, 5
  • It does NOT affect Factor V (Factor 5) in any way 1
  • It does NOT interact with platelet factor 4 (PF4) or cause immune-mediated platelet effects 6

Clinical Indications for Apixaban

The European Respiratory Review and Journal of Thrombosis and Haemostasis confirm that apixaban is approved for: 1

  • Treatment and secondary prevention of venous thromboembolism (VTE) including deep vein thrombosis and pulmonary embolism 7, 4
  • Prevention of stroke and systemic embolism in nonvalvular atrial fibrillation 1
  • VTE prophylaxis after major orthopedic surgery 5

Factor V Leiden: A Different Entity

Factor V Leiden is a genetic thrombophilia (hypercoagulable state), not a target for anticoagulation. While patients with Factor V Leiden who develop thrombosis may be treated with apixaban, the drug does not "treat" Factor V Leiden itself—it prevents and treats the thrombotic complications that can result from this condition. 7

Key Pharmacologic Distinction

  • Factor Xa inhibitors (apixaban, rivaroxaban, edoxaban): Block Factor 10 1
  • Direct thrombin inhibitors (dabigatran): Block Factor IIa (thrombin) 1
  • Vitamin K antagonists (warfarin): Reduce synthesis of Factors II, VII, IX, X, and proteins C and S 1
  • None of these agents target Factor V 1

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

Apixaban: a new player in the anticoagulant class.

Current drug targets, 2012

5
Research

Apixaban: an oral direct factor-xa inhibitor.

Advances in therapy, 2012

6
Guideline

Thrombocytopenia Associated with Apixaban Use

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

7
Guideline

Apixaban Use in Venous Thromboembolism

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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