Everything about Apixaban(Eliquis)
Apixaban powder video
I.Apixaban powder basic Characters:
|Storage Temp:||20°C to 25°C|
|Color:||White to pale-yellow powder|
Apixaban ( 503612-47-3)was approved in the U.S. in 2014 for treatment and secondary prophylaxis of deep vein thrombosis (DVT) and p
ulmonary embolism (PE).It was developed in a joint venture by Pfizer and Bristol-Myers Squibb. Apixaban sold under the brand name(Apixaban brand name) Eliquis. Apixaban is blood-thinning drug, is taken by mouth. It is a direct factor Xa inhibitor.
Eliquis is the brand name of Apixaban(503612-47-3),ELIQUIS (apixaban), a factor Xa (FXa) inhibitor, is chemically described as 1-(4-methoxyphenyl)-7-oxo-6-[4-(2-oxopiperidin-1-yl)phenyl]-4,5,6,7-tetrahydro-1H-pyrazolo[3,4c]pyridine-3-carboxamide. Its molecular formula is C25H25N5O4, which corresponds to a molecular weight of 459.5. Apixaban has the following structural formula:
ELIQUIS tablets(apixaban) – Structural Formula
Apixaban is a white to pale-yellow powder. At physiological pH (1.2-6.8), apixaban does not ionize; its aqueous solubility across the physiological pH range is ~0.04 mg/mL.
ELIQUIS tablets are available for oral administration in strengths of 2.5 mg and 5 mg of apixaban with the following inactive ingredients: anhydrous lactose, microcrystalline cellulose, croscarmellose sodium, sodium lauryl sulfate, and magnesium stearate. The film coating contains lactose monohydrate, hypromellose, titanium dioxide, triacetin, and yellow iron oxide (2.5 mg tablets) or red iron oxide (5 mg tablets).
Apixaban is an anticoagulant for the treatment of venous thromboembolic events,is indicated for the following:
-Apixaban is used for reducing the risk of blood clots in the heart and strokes in patients with atrial fibrillation who have no problems with their heart valves (nonvalvular atrial fibrillation).
-Apixaban is also is used for treating and preventing deep venous thrombosis (DVT) and pulmonary embolism in patients who have undergone hip or knee replacement surgery.
Apixaban can be taken by adults aged 18 and over.
Apixaban isn’t suitable for some people. Tell your doctor if you:
-have had an allergic reaction to apixaban or any other medicines in the past
-are trying to get pregnant or are already pregnant – apixaban can be harmful to your baby
-have liver problems
-have had a recent spinal injury or surgery
-are taking any other medicines that affect blood clotting, such as warfarin
-have any injuries that are currently bleeding a lot (such as a wound or a stomach ulcer)
-are taking the herbal remedy St John’s wort (often taken for depression)
What is Apixaban dosing(apixaban dose) and how to take apixaban? Apixaban uses may include as bellow:
·The usual apixaban dose in nonvalvular atrial fibrillation is 5 mg by mouth twice daily. For individuals 80 years or older, weighing less than or equal to 60 kg, or with reduced kidney function, the usual dose is 2.5 mg twice daily.
·The recommended apixaban dose for treating DVT or pulmonary embolism is 10 mg twice daily for the first 7 days and then 5 mg twice daily. After six months of treatment, the apixaban dosage may be reduced to 2.5 mg daily for prevention of DVT or pulmonary embolism.
·For people who’ve recently had a blood clot – if you’ve had a blood clot within the last 6 months, the usual apixaban dosage is two 5mg tablets, twice a day, for the first 7 days. After that, you’ll take one 5mg tablet twice a day.
·For people taking it to reduce the risk of a future blood clot – if you had a blood clot more than 6 months ago, the usual apixaban dosing is one 2.5mg tablet twice a day.
-Apixaban over doses
Ask your doctor or pharmacist for advice straight away as overdose puts you at risk of bleeding.
-Apixaban missed doses
Take your medicine as soon as you remember, unless it’s nearly time for your next dose. Do not take a double dose to make up for a missed one. Take your next dose at the usual time, and then carry on as normal.
It’s very important that you remember to take apixaban every day. If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
There are no adequate studies in pregnant women. Use during pregnancy may increase the risk of bleeding during pregnancy and delivery. Apixaban should be avoided during pregnancy.
It is not known if apixaban is excreted in human milk. Nursing mothers should discontinue apixaban or discontinue nursing.
How long you need to take apixaban will depend on why you’re taking it.
·If you’ve had knee replacement surgery, you’ll usually take the tablets for 10 to 14 days.
·If you’ve had a hip replacement, you’ll usually take the tablets for 32 to 38 days.
·If you’ve had a blood clot (DVT or pulmonary embolism), you’ll normally take apixaban for at least 3 months. Depending on what caused the blood clot, you might need to take it for longer.
·If you have atrial fibrillation, you might need to take apixaban long term or even
for the rest of your life.
Drug interactions(apixaban contraindications) may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: mifepristone, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, “blood thinners” such as warfarin, enoxaparin), certain antidepressants (including SSRIs such as fluoxetine, SNRIs such as desvenlafaxine/venlafaxine).
Other medications can affect the removal of apixaban from your body, which may affect how apixaban works. Examples include certain azole antifungals (such as itraconazole, ketoconazole, posaconazole), conivaptan, HIV protease inhibitors (such as lopinavir, ritonavir), rifamycins (such as rifabutin), St. John’s wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen, naproxen) that may increase your risk for bleeding if taken together with this medication. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
It is best not to drink a lot of alcohol while taking this medication. If you choose to drink alcohol, do not drink more than 2 standard drinks a day. Do not stop taking this medication without checking with your health care team first. Tell the staff right away that you take apixaban. If you choose to drink alcohol, do not drink more than 2 standard drinks a day.
One standard drink means:
• 1.5 oz or 43 ml of liquor or spirits. This is 40% alcohol.
• 5 oz or 142 ml of wine. This is 12% alcohol.
• 12 oz or 341 ml of regular strength beer. This is 5% alcohol.
• Higher alcohol beer and coolers have more alcohol than one standard drink
The new blood thinner drugs are called Pradaxa (dabigatran), Xarelto (rivaroxaban), Eliquis (apixaban), and most recently, Savaysa (edoxaban).
Taking apixaban with everyday painkillers. You can take paracetamol while you’re taking apixaban. Do not take aspirin or ibuprofen while you’re taking apixaban unless a doctor has said it’s OK to. They increase the chance of bleeding.
if you are taking a blood-thinning drug, DO NOT stop using it and DO NOT begin any vitamin K supplementation on your own. Instead, speak with your doctor about starting a vitamin K supplement at a proper dose. With careful monitoring of coagulation tests, you are likely to find a balance between the benefits and the risks of anticoagulant use.
Newer blood-thinning drugs such as Pradaxa(dabigatran) and Eliquis(apixaban) are not affected by vitamin K intake, meaning you can take full-dose vitamin K and not compromise the desired anticoagulant effects.
Some apixaban side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:
-heavy vaginal bleeding
-red, pink, or brown urine
-red or black, tarry stools
-coughing up or vomiting blood or material that looks like coffee grounds
-swelling or joint pain
-chest pain or tightness
-swelling of the face or tongue
-feeling dizzy or faint
Apixaban prevents blood from clotting normally, so it may take longer than usual for you to stop bleeding if you are cut or injured. This medication(apixaban side effects) may also cause you to bruise or bleed more easily. Call your doctor right away if bleeding or bruising is unusual, severe, or cannot be controlled.
Do not stop taking apixaban without talking to your doctor.
If you stop taking apixaban, the rate at which your blood clots will return to what it was before you started taking it – usually within a day or two of stopping. This means that you may be at increased risk of serious problems like stroke, heart attack, DVT or pulmonary embolism.
-Do not stop taking apixaban without talking to your doctor. Stopping apixaban when you are not supposed to may raise the chance of blood clots. This includes stroke in certain people. You may need to stop apixaban before certain types of dental or health care. Your doctor will tell you when to start taking it again. Follow what your doctor tells you closely.
-People who have any type of spinal or epidural procedure are more likely to have bleeding problems around the spine when already on this drug. This bleeding rarely happens, but can lead to not being able to move body (paralysis) long-term or paralysis that will not go away. The risk is raised in people who have problems with their spine, a certain type of epidural catheter, or have had spinal surgery. The risk is also raised in people who take any other drugs that may affect how the blood clots like blood-thinner drugs (like warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs). Talk with the doctor.
-Tell your doctor you use apixaban before you have a spinal or epidural procedure. Call your doctor right away if you have any signs of nerve problems like back pain, numbness or tingling, muscle weakness, paralysis, or loss of bladder or bowel control.
-Talk with your doctor if you have recently had or will be having a spinal or epidural procedure. Some time may need to pass between the use of apixaban and your procedure. Talk with your doctor.
Apixaban is a type of medicine known as an anticoagulant – or blood thinner. It makes your blood flow through your veins more easily. This means your blood will be less likely to make a dangerous blood clot.