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Safety Advices
বাংলা
English
CAUTION
Caution is advised when consuming alcohol with Apixa 5. Please consult your doctor.
SAFE IF PRESCRIBED
Apixa 5 is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.
CONSULT YOUR DOCTOR
Apixa 5 is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
SAFE
Apixa 5 does not usually affect your ability to drive.
CAUTION
Apixa 5 should be used with caution in patients with kidney disease. Dose adjustment of Apixa 5 may be needed. Please consult your doctor.
CAUTION
Apixa 5 should be used with caution in patients with liver disease. Dose adjustment of Apixa 5 may be needed. Please consult your doctor.
Dose adjustment is not needed in patients with the mild liver disease.
Medicine Overview of Apixa 5mg Tablet
Introduction
Apixa 5 is a medicine known as an anticoagulant or blood thinner. It helps prevent and treat blood clots. It is used to reduce the risk of stroke and heart attack. It prevents and treats clot formation in the veins of your legs, lungs, brain and heart. Apixa 5 is commonly used in patients with irregular heart rhythm (atrial fibrillation) to prevent clot formation. It also reduces the risk of getting clots in people who have undergone knee or hip replacement surgeries. It can be taken with or without food and it is best to take them at the same...
... Show moreUses of Apixa 5
- Deep vein thrombosis
- Pulmonary embolism
- Stroke prevention
How to use Apixa 5
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Apixa 5 may be taken with or without food, but it is better to take it at a fixed time.
How Apixa 5 works
Apixa 5 is a novel oral anticoagulant (NOAC). It works by preventing the formation of blood clots in the body.
What if you forget to take Apixa 5?
If you miss a dose of Apixa 5, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Quick Tips
- For best results, take Apixa 5 at the same time every day. It is better to take at night with meals
- It interacts less with food or other medicines. Hence, frequent dose changes are not required.
- It increases your risk of bleeding. Be careful while shaving, cutting fingernails or toenails, using sharp objects or engaging in contact sports (e.g. football, wrestling).
- Inform your doctor if you see blood in your vomit, urine or stool (black, tarry stools or bright red blood).
- If you are going to have a surgery or dental treatment, you may be asked to stop taking Apixa 5 temporarily.
- Notify your doctor if you have any kidney problem.
- Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
- Do not stop taking medication without talking to your doctor.
Brief Description
Indication
Indicated to reduce risk of stroke and systemic embolism associated with nonvalvular atrial fibrillation, Postoperative Prophylaxis of DVT/PE following hip or knee replacement surgery, Deep venous thrombosis (DVT), Pulmonary embolism (PE),
Administration
May be taken with or without food.
Adult Dose
Oral Adult Prevention of VTE: Elective hip or knee replacement surgery Tablet 2.5 mg twice daily. Initial dose should be taken 12-24 hr post-op. Recommended duration of treatment: Patient undergoing hip replacement surgery 32-38 days. Patient undergoing knee replacement surgery 10-14 days. Prevention of stroke and systemic embolism in non-valvular atrial fibrillation Adult: 5 mg bid. Decrease dose to 2.5 mg PO BID in patients with any 2 of the following characteristics: Age ?80 years Weight ?60 kg Serum creatinine ?1.5 mg/dL Oral Deep vein thrombosis, Pulmonary embolism Adult: 10 mg bid for 7 days, followed by 5 mg bid....
... Show moreRenal Dose
Renal impairment, including with ESRD on dialysis Deep Vein Thrombosis: No dose adjustment recommended; clinical efficacy and safety studies did not enroll patients with ESRD on dialysis or patients with a CrCl <15 mL/min; dosing recommendations are based on pharmacokinetic and pharmacodynamic (anti-FXa activity) data in study subjects with ESRD maintained on dialysis Renal impairment (nonvalvular atrial fibrillation) Mild-to-moderate: No dosage adjustment required 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...
... Show moreContraindication
Hypersensitivity. Clinically significant active bleeding. Hepatic disease associated w/ coagulopathy & clinically relevant bleeding risk. Lesion or condition at significant risk of major bleeding. Concomitant treatment w/ other anticoagulant agent.
Mode of Action
Apixaban is an anticoagulant that inhibits platelet activation and fibrin clot formation via direct, selective and reversible inhibition of free and clot-bound factor Xa in both intrinsic and extrinsic coagulation pathways. Inhibition of coagulation factor Xa prevents conversion of thrombin and subsequent thrombus formation.
Precaution
Increased risk of hemorrhage eg, congenital or acquired bleeding disorders; active ulcerative GI disease; bacterial endocarditis; thrombocytopenia; platelet disorders; history of haemorrhagic stroke; severe uncontrolled HTN; recent brain, spinal or ophthalmological surgery. Discontinue use if severe haemorrhage occurs. Renal impairment (CrCl <15 mL/min). Contraindicated in patients w/ hepatic disease associated w/ coagulopathy & clinically relevant bleeding risk. Not recommended in patients w/ severe hepatic impairment. Patients w/ mild or moderate hepatic impairment (Child Pugh A or B). Low body wt (<60 kg). Patients receiving concomitant systemic treatment w/ strong inhibitors of both CYP3A4 & P-gp eg, azole antimycotics (eg, ketoconazole,...
... Show moreSide Effect
Epistaxis, haematoma, anaemia, haematuria, contusion, nausea; GI, rectal or gingival haemorrhage.
Potentially Fatal: Epidural or spinal haematoma, fatal bleeding.
Pregnancy Category Note
Pregnancy There are no adequate and well-controlled studies in pregnant women Treatment is likely to increase the risk of hemorrhage during pregnancy and delivery Use of anticoagulants, during pregnancy, may increase risk of bleeding in fetus and neonate Pregnancy confers an increased risk of thromboembolism that is higher for women with underlying thromboembolic disease and certain high-risk pregnancy conditions Published data describe that women with a previous history of venous thrombosis are at high risk for recurrence during pregnancy Therapy should be administered during pregnancy only if the potential benefit outweighs the potential risk to the mother and fetus Animal...
... Show moreInteraction
Increased exposure w/ strong dual CYP3A4 and P-glycoprotein (P-gp) inhibitors (e.g. clarithromycin, itraconazole, ketoconazole, ritonavir). Increased risk of bleeding w/ drugs affecting haemostasis (e.g. aspirin, heparin, fibrinolytics, SSRIs, NSAIDs, serotonin norepinephrine reuptake inhibitors). Increased risk of stroke w/ strong dual CYP3A4 and P-gp inducers (e.g. rifampicin, phenytoin, carbamazepine).
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