APIXABAN

Apixaban is an anticoagulant that belongs to the class of Factor Xa inhibitors. It was approved on 28 December 2012 for the prevention of blood clots.

Apixaban has been developed as a direct oral anticoagulant (DOACs) drug to prevent strokes and blood clots in people with atrial fibrillation, deep vein thrombosis, or pulmonary embolism.

Your doctor will decide the dose and duration of Apixaban based on the disease condition. Always take this medicine as prescribed by your doctor. The recommended starting oral dose of axitinib is 2.5 mg twice daily. Take the tablet at the same time everyday, with or without food. Do not chew, crush, or break the tablet. Swallow the whole tablet with water. If you forgot to take the tablet, simply take your next dose at the scheduled time. Do not take a double dose to make up for a forgotten dose.

The common side effects that are likely to occur while you are on the treatment with Apixaban are fainting, low blood pressure, skin rash, hair loss, itching and reduced number of platelets. If you experience any allergic or unusual reactions after taking this medicine, report to your doctor immediately.

This medicine can interact with other anticoagulant medications and it increases the risk of spinal or epidural hematoma (a blood clot that forms in the spinal canal), particularly if patients undergo spinal procedures or receive spinal anaesthesia. Therefore, patients taking this drug should inform their doctor before undergoing any medical procedures, including dental work or surgery, so that appropriate precautions can be taken. Clinicians should also monitor patients frequently for signs and symptoms of neurological impairment, such as numbness or tingling in the arms or legs, weakness, or loss of bowel or bladder control. If these symptoms occur, urgent treatment is necessary to prevent further neurological damage. During the treatment, your doctor may periodically monitor your complete blood counts, prothrombin time, INR, blood sugar, electrolytes, liver panel, and kidney parameters to prevent serious complications.

This drug is not recommended during pregnancy as it causes harm to the unborn baby. Tell your healthcare provider before beginning this treatment if you are pregnant or planning to have a baby. It is not known whether this medicine is excreted in human milk, please consult your doctor before breastfeeding. This drug is contraindicated in patients with hepatic disease associated with coagulopathy and clinically relevant bleeding risk, and it is not recommended in patients with severe hepatic impairment. Some formulations of this drug may contain lactose as an inactive ingredient in which the body is unable to digest lactose, a sugar found in milk and dairy products. It can cause symptoms such as bloating, and abdominal pain. If you have lactose intolerance, inform your doctor before starting this therapy.

Apixaban increases the risk of bruising, so care should be taken when handling sharp objects or engaging in activities that may cause injury. Inform your doctor before any medical procedure, including dental treatment or surgery, so appropriate precautions can be implemented. Disclose all medications you are taking to your doctor, including over-the-counter drugs, supplements, and herbal preparations. Maintain consistent intake of high-fibre foods such as fruits, vegetables, and whole grains, as this helps regulate bowel movements and reduces the likelihood of constipation, which can increase bleeding risk.

Bristol Myers Squibb/Pfizer EEIG; Electronic Medicines Compendium; [Revised:2021] [Accessed on 03/Apr/2023] https://www.medicines.org.uk/emc/files/pil.4756.pdf Highlights of prescribing information; food and drug administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/211964s000lbl.pdf [Accessed on 03/Apr/2023] . Annex I summary of Product Characteristics - European Medicines Agency; Available at: https://www.ema.europa.eu/en/documents/product-information/eliquis-epar-product-information_en.pdf [Accessed on 03/Apr/2023]. Katherine Victoria Hurst, John Matthew O’Callaghan and Ashok Handa; ; Quick reference guide to Apixaban; Published 2017 [Accessed on 03/Apr/2023] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513886/#__ffn_sectitle SL Greig; Apixaban: A review in venous thromboembolism; [Published:2016] [Accessed on 03/Apr/2023] https://pubmed.ncbi.nlm.nih.gov/27653758/ Goodman & Gilman’s, The Pharmacological Basis of Therapeutics,Modulation of Cardiovascular Function, 12th edition, 2011, 867. Bertram.G.Katzung, Basic and Clinical Pharmacology, Drugs Used to Treat Diseases of the Blood, Inflammation, & Gout, 14th edition, 617