Apixaban is a novel oral anticoagulant classified as a direct factor Xa inhibitor. It is primarily used for the prevention and treatment of deep vein thrombosis (DVT), pulmonary embolism (PE), and for reducing the risk of stroke in patients with atrial fibrillation. This medication inhibits the activity of factor Xa in the blood coagulation process, effectively reducing thrombus formation while lowering dietary restrictions and monitoring frequency associated with traditional warfarin therapy.
Compared to traditional anticoagulants, apixaban offers advantages such as fixed dosing and no dietary restrictions, but it must be used strictly according to medical instructions to avoid serious side effects like bleeding.
Brand Name: Eliquis Generic Name: Apixaban
This medication is marketed under the brand name Eliquis in Taiwan and Hong Kong and is a prescription drug requiring a doctor's prescription for use.
Apixaban is classified as a "Direct Oral Anticoagulant" (DOAC), specifically targeting factor Xa, which inhibits the conversion of prothrombin to thrombin, thereby preventing clot expansion.
This class of drugs differs from traditional anticoagulants like warfarin in mechanism, with rapid onset of action and a shorter half-life, but interactions with other medications should be carefully monitored.
Doctors may adjust doses based on patient age and renal function; for example, patients with severe kidney disease may require reduced doses to prevent excessive anticoagulation.
Mild side effects include:
Serious side effects requiring immediate medical attention include:
Contraindications:
Pregnancy is classified as Category C; use only if necessary. Patients should inform their healthcare provider before surgery to evaluate the timing of discontinuation. Elderly patients require careful monitoring for bleeding risks.
Concurrent use with the following medications may increase bleeding risk:
Avoid combining with strong CYP3A4 inducers (e.g., carbamazepine), which may reduce drug efficacy. Consult a healthcare professional before using herbal supplements.
Dosage varies according to condition:
Take the medication whole; do not chew. It can be taken with or without food. In case of overdose, seek immediate medical attention; currently, there is no specific antidote.
If a dose is missed and more than 6 hours remain until the next scheduled dose, take the missed dose immediately and continue with the regular schedule. If it is close to the next dose, skip the missed dose and do not double up. Do not delay treatment due to missed doses; establish a fixed medication reminder system, such as alarms or pill organizers.
Overdose may cause subcutaneous bruising, hematuria, or hematemesis, and requires urgent medical attention. Emergency measures include monitoring coagulation function, blood transfusions, or administering specific clotting factor concentrates.
Emergency: If unconsciousness, severe headache, or unexplained bleeding occurs, go to the emergency room immediately; do not attempt self-treatment.
Apixaban can be taken with or without food, but it is recommended to take it at the same time each day to maintain stable drug levels. Avoid taking it with high-fat meals, as this may increase absorption variability. Dietary restrictions are generally not necessary, but excessive intake of grapefruit or grapefruit juice may affect drug metabolism; it is advised not to exceed 1 liter of grapefruit juice daily.
What should I do if I notice minor bleeding signs (such as gum bleeding) while on medication?Minor bleeding like gum bleeding or nosebleeds can be managed by applying pressure and cold compresses. If bleeding persists for more than 10 minutes or occurs frequently, consult your doctor to evaluate whether dose adjustment is necessary. Bleeding is a common side effect of anticoagulants but should be closely monitored for accompanying symptoms like headache or abdominal pain.
What interactions should I be aware of when using other anticoagulants?Using apixaban with warfarin, heparin, or other anticoagulants may increase bleeding risk and is generally not recommended. When combined with NSAIDs like ibuprofen, dose adjustments should be made under medical supervision. When used with drugs affecting P-glycoprotein (e.g., quinidine), coagulation parameters should be monitored.
Should I stop medication before dental procedures or minor surgeries?For invasive procedures such as tooth extraction or endoscopy, consult your doctor 3 to 5 days in advance to determine whether to temporarily discontinue medication. The doctor will assess the bleeding risk and may recommend bridging anticoagulation therapy to balance the risks of thrombosis and bleeding.
Is routine blood monitoring necessary for long-term use?Unlike warfarin, apixaban generally does not require regular INR monitoring. However, if the patient has liver or kidney dysfunction or shows signs of severe bleeding, the doctor may order coagulation tests such as aPTT or renal function tests. It is advisable to report any physical reactions or side effects during follow-up visits every 3 to 6 months.
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