Patients being treated for acute DVT or PE should receive apixaban 10mg twice for the first 7 days, followed by 5mg twice daily.
The recommended dose for the prevention of recurrent DVT or PE in adults is 2.5mg twice daily, following 6 months of apixaban at the treatment dose or another conventional anticoagulant.
Apixaban is not recommended for haemodynamically unstable PE or patients who require thrombolysis or pulmonary embolectomy, and for patients with active cancer.
Mechanism of action
In the double-blind 12-month AMPLIFY trial, apixaban was non-inferior to enoxaparin/warfarin for the prevention of recurrent VTE/VTE-related death, and was associated with a lower risk of major bleeding (RR 0.31, 95% CI 0.17–0.55, p<0.0001).
In the double-blind, placebo-controlled 12-month extension trial AMPLIFY-EXT (n=2486), patients treated with apixaban had a significantly lower rate of recurrent VTE/all-cause death than those given placebo (1.7% vs 8.8%, p<0.001) and rates of major bleeding did not differ significantly between the groups.
This latest indication update means that the licensed indications of Eliquis are now the same as those of Xarelto (rivaroxaban) and Pradaxa (dabigatran).
Further information: BMS