Use of apixiban is restricted to patients with one or more risk factors for stroke or systemic embolism, including:
- prior stroke or transient ischaemic attack
- age ≥75 years
- diabetes mellitus
- symptomatic heart failure.
The decision to start treatment with apixaban should be based on a risk to benefit analysis of the oral factor Xa inhibitor compared with warfarin, dabigatran and rivaroxaban. In patients currently receiving warfarin, the existing level of INR control should be taken into account.