Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
Pharmacodynamics:Anticoagulant of direct action, intended for oral administration. Selectively and reversibly blocks free and bound factor Xa and thromboxinase activity. The antithrombotic effect of the drug does not depend on the presence of antithrombin III.
Pharmacokinetics:After absorption in the stomach, the maximum concentration of the drug in the blood plasma is noted after 3-4 hours. When taking the drug in a dose of more than 10 mg, the absorption slows down, its bioavailability decreases.
Binding to blood proteins is about 87%.
The half-life is 12 hours. Biotransformation by O-demethylation and hydroxylation of the 3-oxopiperidine residue. Apixaban is a substrate of P-glycoprotein, transport proteins and protein resistance of breast cancer.
Elimination of 25% of the drug in the form of metabolites mostly through the intestine. Renal excretion is about 27%.
Indications:It is used for preventive purposes after operations on endoprosthetics of the hip and knee joints.Used to prevent strokes and systemic thromboembolism in patients with atrial fibrillation.
IX.I80-I89.I82 Embolism and thrombosis of other veins
IX.I70-I79.I74 Embolism and thrombosis of the arteries
Contraindications:Bleeding, impaired liver and kidney function (creatinine clearance less than 15 ml per minute).
Patients on dialysis.
Individual intolerance.
Carefully:With the risk of bleeding, the drug is taken under strict control of the coagulogram - twice a day. With the development of bleeding, apiabaxane is withdrawn. If necessary, transfusion of fresh-frozen blood plasma is performed.
Pregnancy and lactation:Pregnancy and lactation: recommendations for Food and Drug Administration (US Food and Drug Administration) - not defined. It is not recommended to take the drug during pregnancy. There is no evidence of ingestion into breast milk. When taking the drug should stop breastfeeding.
Dosing and Administration:Inside for 1 tablet (2.5 mg) 2 times a day, regardless of food intake.
After surgery for hip replacement, the course of treatment is 30-40 days, the knee joint - 10-14 days.
The effect of the drug does not depend on body weight.
The highest daily dose: 5 mg.
The highest single dose: 2.5 mg.
Side effects:The system of hematopoiesis: anemia, less often - thrombocytopenia.
Respiratory system: epistaxis, less often hemoptysis.
Cardiovascular system: arterial hypotension.
Visual analyzer: hemorrhages in the conjunctiva.
Digestive system: nausea, gastrointestinal bleeding (melena), increased alanine aminotransferase, aspartate aminotransferase, bleeding gums.
Urinary system: hematuria.
Reproductive system: uterine bleeding.
Allergic reactions.
Overdose:Bleeding.
Treatment is symptomatic, including surgery.
Interaction:The effect of the drug is not dependent on food intake.
Simultaneous administration of apixaban with acetylsalicylic acid and heparin preparations increases the risk of bleeding.
Special instructions:During the administration of apixaban, the hemostatic system should be monitored - monitor the coagulogram.
Performing manipulations on the spinal column (spinal puncture) when taking apixaban threatens with hematomas, causing persistent paralysis and paresis of the lower limbs.Before intervention, it is necessary to cancel taking the drug for one day.