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Apixaban Drug Class

Apixaban Drug Class


Let's say you have an 80 year old grandmother who has an arthritic knee. She wants to undergo knee replacement surgery. After surgery, she is at risk of developing blood clots in the legs that will then travel to the lungs and causing difficulty breathing, if not death. You'd want to prevent this right? Of course!

Well, you could choose one of several different medications to try and prevent blood clot formation, including aspirin, warfarin, dabigatran, and many others. One other possibility is known as apixaban, better known as Eliquis by its trade name. Let's go over this medication's drug class and structure in this lesson.

Drug Class

Apixaban is best broadly described as a blood thinner. This is a misnomer, however. This is because blood thinners don't actually thin out or dilute your blood. Blood thinners make your blood less likely to clot, that's all.

Blood thinners come in two major categories. They can either be antiplatelet drugs, like the famous aspirin can be, or they can be anticoagulants, like the famous warfarin (Coumadin). Don't get these two general types of blood thinners confused with thrombolytics, however. Thrombolytics are better known as 'clot busters'. In other words, they dissolve clots after they have formed. Anticoagulants and antiplatelet medications try to prevent clots from forming in the first place.

Side effects

Apixaban can increase the risk of bleeding which may be serious and potentially fatal. Concurrent use with drugs that affect hemostasis can further increase this risk. This includes drugs such as other anticoagulants, heparin, aspirin, antiplatelet drugs, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs)[5]

One concern with the use of apixaban and the other newer anticoagulants is the absence of well-established protocol for reversal of their activity (no antidote is available). This is an important disadvantage relative to warfarin when bleeding complications occur, or when people taking the drugs require emergency surgery.

What is the dosage for apixaban?

The usual 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 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 dose may be reduced to 2.5 mg daily for prevention of DVT or pulmonary embolism.

Why is this medication prescribed?

Apixaban is used help prevent strokes or blood clots in people who have atrial fibrillation (a condition in which the heart beats irregularly, increasing the chance of clots forming in the body and possibly causing strokes) that is not caused by heart valve disease. Apixaban is also used to prevent deep vein thrombosis (DVT; a blood clot, usually in the leg) and pulmonary embolism (PE; a blood clot in the lung) in people who are having hip replacement or knee replacement surgery. Apixaban is also used to treat DVT and PE and may be continued to prevent DVT and PE from happening again after the initial treatment is completed. Apixaban is in a class of medications called factor Xa inhibitors. It works by blocking the action of a certain natural substance that helps blood clots to form.


You may have a higher risk of bleeding if you take apixaban and take other medicines that increase your risk of bleeding, including:

  • aspirin or aspirin-containing products
  • long-term (chronic) use of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • warfarin sodium (Coumadin, Jantoven)
  • any medicine that contains heparin
  • selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)
  • other medicines to help prevent or treat blood clots

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