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Highlights

• Reduction of risk of stroke & systemic embolism in non valvular atrial fibrillation.
• Prophylaxis of deep vein thrombosis following hip or knee replacement surgery.
• Treatment of deep vein thrombosis.
• Reduction in the risk of reoccurence of DVO & PE.

Directions For Use

For patients who are unable to swallow whole tablets 5 mg apixaban tablets may be crushed and suspended in water, 5% dextrose in water (D5W), or apple juice, or mixed with applesauce and promptly administered orally. Alternatively, apixaban tablets may be crushed and suspended in 60 mL of water or D5W and promptly delivered through a nasogastric tube.

Warnings

• There are no adequate and well-controlled studies of apixaban in pregnant women. Treatment is likely to increase the risk of hemorrhage during pregnancy and delivery. Apixaban should be used during pregnancy only if the potential benefit outweighs the potential risk to the mother and fetus.
• It is unknown whether apixaban or its metabolites are excreted in human milk. Women should be instructed either to discontinue breastfeeding or to discontinue apixaban therapy, taking into account the importance of the drug to the mother.
• Safety and effectiveness in pediatric patients have not been established.

Precautions

• Increased Risk of Stroke with Discontinuation of apixaban.If apixaban must be discontinued for a reason other than pathological bleeding, consider coverage with another anticoagulant.
• Apixaban increases the risk of bleeding and can cause serious, potentially fatal, bleeding. Concomitant use of drugs affecting hemostasis increases the risk of bleeding. These include aspirin and other antiplatelet agents, other anticoagulants, heparin, thrombolytic agents, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitor, and nonsteroidal anti-inflammatory drugs (NSAIDs). Patients should be made aware of signs and symptoms of blood loss and instructed to report them immediately or go to an emergency room. Apixaban should be discontinued in patients with active pathological hemorrhage.