Apixaban

Evidence-based neurology checklist on apixaban: Pharmacology Apixaban is a factor Xa inhibitor It is superior to warfarin It is excreted via the liver: via the CYP3A4 enzyme pathway It has less bleeding and lower mortality than Warfarin The bleeding risk is not higher than that of Aspirin…

Pharmacology

  • Apixaban is a factor Xa inhibitor
  • It is superior to warfarin
  • It is excreted via the liver: via the CYP3A4 enzyme pathway
  • It has less bleeding and lower mortality than Warfarin
  • The bleeding risk is not higher than that of Aspirin

Indications

Dose in stroke prophylaxis

Dose monitoring

Indications for using 2.5mg twice daily: ≥2 of

Precautions

Management of bleeding: Andexanet alfa

Management of bleeding: other measures

References

  1. Mezue K, Obiagwu C, John J, Sharma A, Yang F, Shani J. Novel Oral Anticoagulants in Atrial Fibrillation: Update on Apixaban. Curr Cardiol Rev; 13:41-46. 
  2. Tendera M, Syzdol M, Parma Z. ARISTOTLE RE-LYs on the ROCKET. What's new in stroke prevention in patients with atrial fibrillation? Cardiol J 2012; 19:4-10.
  3. Flaker GC, Eikelboom JW, Shestakovska O, et al. Bleeding during treatment with aspirin versus apixaban in patients with atrial fibrillation unsuitable for warfarin: the apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment (AVERROES) trial. Stroke 2012; 43:3291-3297. 
  4. Granger CB, Alexander JH, McMurray JJ, et al; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365:981-992.
  5. Kamel H, Longstreth WT Jr, Tirschwell DL, et al. Apixaban versus aspirin and risk of hemorrhage in the ARCADIA trial. Ann Neurol 2026 (Online ahead of print).
  6. And 3 more. Subscribe to see the full list

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