Stroke Prevention

Stroke Prevention

An ischemic stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.

Apixaban is an anticoagulant indicated for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation, and deep vein thrombosis (DVT) leading to pulmonary embolism (PE), including in patients who have undergone hip or knee replacement surgery. Apixaban is an oral, direct, and highly selective factor Xa (FXa) inhibitor of both free and bound FXa, as well as prothrombinase. It is marketed under the name Eliquis. It can be purchased online using Apixaban price in order to reduce the cost of purchase. Apixaban was approved by the FDA on December 28, 2012

USES OF ELIQUIS

Dosage Forms & Strengths

It is available in tablet

  • 2.5mg
  • 5mg

Doses of Eliquis

Stroke Prophylaxis with Atrial Fibrillation

5 mg PO BID

Renal impairment (nonvalvular atrial fibrillation)

  • Serum creatinine ≥1.5 mg/dL: Decrease dose to 2.5 mg BID if patient has 1 additional characteristic of age ≥80 years or weight ≤60 kg
  • ESRD maintained on hemodialysis: 5 mg BID; decrease dose to 2.5 mg BID if 1 additional characteristic of age ≥80 years or weight ≤60 kg is present

Deep Vein Thrombosis 

No dose adjustment recommended; not studied in ESRD on dialysis or patients with a CrCl <15 mL/min; dosing recommendations based on pharmacokinetic and pharmacodynamic (anti-FXa activity) data in study subjects with ESRD maintained on dialysis

DVT or PE Treatment

10 mg PO BID x 7 days, then 5 mg BID

MECHANISM OF ACTION

Factor Xa inhibitor that inhibits platelet activation by selectively and reversibly blocking the active site of factor Xa without requiring a cofactor (eg, antithrombin III) for activity.

Inhibits free and clot-bound factor Xa, and prothrombinase activity; no direct effect on platelet aggregation, but indirectly inhibits platelet aggregation induced by thrombin

Blood coagulation cascade is dependent on the activation of factor X to factor Xa via the intrinsic and extrinsic pathways, which play a central role in the blood coagulation cascade

Adverse Effects

The most frequent adverse reactions associated with the usage of Eliquis for all indications are bleeding-related. Apixaban can increase the risk of bleeding, which can be life-threatening or fatal. Use concurrently with other blood-thinning drugs can substantially raise this risk. The Food and Drug Administration (FDA) has approved Andexanet alfa as an antidote for apixaban in patients with uncontrolled and life-threatening bleeding episodes. Science news articles are a great way to learn about new ideas, discoveries in research.

People being treated with anti-thrombotic medications are at a greater risk of developing a hematoma following spinal anesthetic or puncture, which can result in long-term or permanent paralysis. This risk may be exacerbated by the use of epidural or intrathecal catheters after a surgical procedure, as well as the concurrent administration of medications that alter hemostasis.

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