Eliquis

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Eliquis: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Eliquis

ATX code: B01AF02

Active ingredient: apixaban (apixaban)

Manufacturer: BRISTOL-MYERS SQUIBB Manufacturing Company (Puerto Rico)

Description and photo updated: 2018-23-11

Prices in pharmacies: from 741 rubles.

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Eliquis is a factor Xa inhibitor, a direct anticoagulant.

Release form and composition

Dosage form - film-coated tablets:

Elikvis 2.5 mg: Round, biconvex, yellow, engraved on one side "893", on the other - "2 ¹ / ₂ " (10 pieces in blister packs in a cardboard bundle 1, 2, 6 or 10 blisters).;
Eliquis 5 mg: oval, biconvex, pink, engraved on one side "894", on the other - "5" (10 pcs. In blisters, in a cardboard box 2, 4, 6 or 10 blisters; 14 pcs. In blisters, in a cardboard box 4 blisters).

Composition of one tablet:

active substance: apixaban - 2.5 or 5 mg;
auxiliary components: sodium croscarmellose, sodium lauryl sulfate, magnesium stearate, microcrystalline cellulose, lactose;
composition of the film shell: 2.5 mg tablets - opadry II yellow (lactose monohydrate, hypromellose 15 cps, triacetin, titanium dioxide, iron oxide yellow dye), 5 mg tablets - opadry II pink (lactose monohydrate, hypromellose 15 cps, triacetin, titanium dioxide, dye iron oxide red).

Pharmacological properties

Pharmacodynamics

Apixaban is a direct-acting anticoagulant. The drug is a selective inhibitor of blood coagulation factor Xa (FXa), selectively and reversibly blocking the active center of the enzyme, for the implementation of antithrombotic activity which does not require the presence of antithrombin III. It inhibits both free and bound FXa and also inhibits prothrombinase activity. It indirectly inhibits thrombin-induced platelet aggregation, but has no direct effect. By inhibiting the activity of FXa, apixaban prevents the formation of thrombin and blood clots. Due to the suppression of this factor, some indicators of the blood coagulation system change: the INR (International Normalized Ratio) increases, the APTT (activated partial thromboplastin time) and prothrombin time are lengthened. When Eliquis is taken in a therapeutic dose, these changes are insignificant and mostly variable, therefore these indicators are not recommended to be used to assess the pharmacodynamic activity of apixaban.

The ability of apixaban to inhibit FXa activity was confirmed by a chromogenic test using Rotachrom heparin. The change in anti-FXa activity is directly proportional to the increase in the plasma concentration of apixaban, with the maximum activity noted when the maximum concentration of the drug in the blood plasma is reached. A linear relationship between the concentration of apixaban and its anti-FXa activity is recorded over a wide range of therapeutic doses of Eliquis. With a change in the dose and concentration of apixaban, changes in anti-FXa activity are more pronounced, but less variable compared to blood clotting indicators.

In patients taking the drug for the prevention of stroke and systemic thromboembolism in nonvalvular atrial fibrillation, the ratio of the maximum and minimum levels of anti-FXa activity in the interval between doses is less than 1.7. In patients who use Eliquis for the treatment of deep vein thrombosis or the prevention of its recurrence, this ratio is less than 2.2, and in patients who are prescribed the drug after planned knee or hip arthroplasty, it does not exceed 1.6.

During the use of apixaban, there is no need to constantly monitor its anticoagulant effect, however, it may be useful to conduct a calibrated quantitative test of anti-FXa activity in cases where information on the level of apixaban in the blood may influence the decision to continue therapy.

Patients receiving apixaban have fewer bleeding episodes than patients receiving warfarin.

Pharmacokinetics

The main pharmacokinetic characteristics of apixaban:

absorption: after ingestion, the substance is rapidly absorbed from the gastrointestinal tract. The maximum concentration is observed 3-4 hours after ingestion. Food does not affect the pharmacokinetic parameters of apixaban. When Eliquis is used in daily doses up to 10 mg, the absolute bioavailability of the drug is about 50%, the pharmacokinetics is linear. In cases of taking the drug in doses of more than 25 mg per day, the absorption of the drug decreases, due to which its bioavailability decreases. Individual variability in apixaban metabolism indicators is low or moderate (20–30%);
distribution: the volume of distribution is approximately 21 liters. The connection with plasma proteins is about 87%;
metabolism: the main pathways of apixaban biotransformation are O-demethylation and hydroxylation at the 3-oxopiperidinyl residue. The drug is metabolized mainly with the participation of the isoenzyme CYP3A4 / 5, to a lesser extent - with the participation of isoenzymes CYP1A2, 2C19, 2C9, 2C8, 2J2. In blood plasma, apixaban circulates unchanged, there are no active metabolites circulating in the bloodstream. Apixaban is also a substrate for breast cancer resistance protein (BCRP), P-glycoprotein and transport proteins;
excretion: apixaban is mainly excreted through the intestines. Renal excretion is about 27% of the total clearance, which is ~ 3.3 L / h. Approximately one fourth of the dose taken is excreted as metabolites. The half-life is 12 hours.

Pharmacokinetics in special clinical situations:

Impaired renal function. There is an increase in the AUC (area under the concentration - time curve) depending on creatinine clearance (CC): with CC 51-80 ml / min - by 16%, with CC 30-50 ml / min - by 29%, with CC CC 15-29 ml / min - 44%, compared with patients with normal CC values. However, impaired renal function does not significantly affect the relationship between the plasma concentration of apixaban and its anti-FXa activity. Studies have not been conducted in patients with CC <15 ml / min and those on dialysis.
Liver dysfunction. In patients with mild and moderate hepatic impairment (class A and B, respectively, according to the Child-Pugh classification) with a single dose of Eliquis at a dose of 5 mg, no changes in the parameters of pharmacodynamics and pharmacokinetics of apixaban were detected, changes in anti-FXa activity and INR were comparable to those in healthy volunteers. With active pathology of the hepatobiliary system and severe hepatic insufficiency, apixaban has not been studied.
Elderly age (over 65). The average AUC is about 32% higher than that of younger patients.
Body mass. In patients weighing> 120 kg, the plasma concentration of apixaban is approximately 30% lower than in those weighing 65–85 kg. In people weighing <50 kg, this figure is about 30% higher.
Floor. In women, the exposure to apixaban is 18% higher than in men.
Race. According to research data, there are no significant differences in the pharmacokinetics of apixaban between representatives of the Caucasian, Negroid, Mongoloid races.

The relationship between the parameters of pharmacokinetics and pharmacodynamics (including anti-FXa activity, MHO, APTT and prothrombin time) of apixaban and its plasma concentration was studied for a wide range of doses - from 0.5 mg to 50 mg. It was found that this dependence is best described using a linear model. The dependence of the pharmacokinetic and pharmacodynamic parameters of apixaban in patients who received the drug in clinical studies of the second and third phases corresponded to that in healthy volunteers.

Indications for use

treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT), prevention of their recurrence;
prevention of venous thromboembolism after knee or hip arthroplasty;
prevention of systemic thromboembolism and stroke in adult patients with nonvalvular atrial fibrillation in the presence of at least one risk factor [such as a history of transient ischemic attack, hypertension, symptomatic chronic heart failure (NYHA functional class II and higher), history of stroke, diabetes mellitus, age 75 years and older], with the exception of patients with artificial heart valves, moderate and severe mitral stenosis.

Contraindications

Absolute:

severe impairment of renal function (CC <15 ml / min) or the need for dialysis;
severe liver dysfunction, as well as liver disease, accompanied by a clinically significant risk of bleeding and disorders in the blood coagulation system;
lactose intolerance, congenital lactase deficiency, glucose-galactose malabsorption;
conditions characterized by an increased risk of bleeding: a history of hemorrhagic stroke, bacterial endocarditis, thrombocytopathy, thrombocytopenia, exacerbation of gastrointestinal ulcer, bleeding disorders (congenital or acquired), severe uncontrolled arterial hypertension, recent organ vision or the brain;
clinically significant bleeding;
age up to 18 years;
period of pregnancy;
lactation;
the need for drug therapy, due to which serious bleeding may develop, with drugs such as heparin derivatives (for example, fondaparinux), any anticoagulants, low molecular weight heparins (for example, dalteparin or enoxaparin), unfractionated heparins, oral anticoagulants (for example, ri dabigatran) or warfarin), except when the patient is transferred to therapy or from therapy with apixaban and when unfractionated heparin is prescribed in maintenance doses to ensure patency of the central venous or arterial catheter;
hypersensitivity to any component of Eliquis.

Relative:

dysfunction of the liver of moderate and mild severity (classes A or B according to the Child-Pugh classification);
an indication in the anamnesis for an urgent surgical intervention for a hip fracture;
simultaneous use of non-steroidal anti-inflammatory drugs (including acetylsalicylic acid);
the combined use of potent inhibitors of the CYP3A4 isoenzyme and P-glycoprotein, such as rifampicin, carbamazepine, phenobarbital, phenytoin, St. John's wort, voriconazole, itraconazole, posaconazole, ketoconazole, HIV protease inhibitors (for example, ritonazole);
the need to use thrombolytic agents for the relief of acute ischemic stroke;
performing spinal / epidural puncture or anesthesia.

Instructions for the use of Eliquis: method and dosage

Eliquis tablets should be taken orally, regardless of the time of meals.

Recommended dosage regimens:

period after planned endoprosthetics of the knee or hip joint: 2.5 mg 2 times a day (taking the first dose is recommended 12-24 hours after surgery). The duration of therapy is 10–14 days after knee replacement, 32–38 days after hip replacement;
atrial fibrillation: Eliquis 5 mg 2 times a day. A 2-fold reduction in the daily dose (2.5 mg twice a day) is required in patients who combine at least two of the following factors: body weight ≤ 60 kg, age ≥ 80 years, plasma creatinine concentration ≥ 1.5 mg / dl (133 μmol / l);
treatment of pulmonary embolism and deep vein thrombosis: the first 7 days - 10 mg 2 times a day, then - 5 mg 2 times a day. The duration of the course of treatment is at least 3 months, depending on the manifestations of the disease, the ratio of the expected benefit and the possible risk of developing clinically significant bleeding, the presence and reversibility of factors predisposing to recurrence (trauma, recent surgery, prolonged immobilization, etc.);
prevention of recurrent pulmonary embolism and DVT: 2.5 mg 2 times a day. Preventive therapy is prescribed after at least 6 months of treatment for these diseases.

If the next dose is missed, it is necessary to take the pill as soon as possible after the patient remembers about it. In the future, you should adhere to the original therapy regimen with taking the drug twice a day. With a temporary interruption in treatment, the risk of thrombosis increases. Patients should be aware of the importance of continuous anticoagulant therapy.

The transfer of a patient to Eliquis from parenteral anticoagulants and vice versa can be carried out at the time of the next scheduled intake of the drug being withdrawn, without using the next dose of the drug that is being replaced.

It is possible to transfer a patient to Eliquis from warfarin or other vitamin K antagonists if the INR value is below 2. When a patient is transferred to warfarin or other vitamin K antagonists, Eliquis should be continued until the INR value reaches ≥ 2. This indicator must be monitored before every reception of apixaban: as soon as it equals or exceeds 2, Eliquis is canceled.

Side effects

The incidence of side effects is assessed on the following scale: often (from ≥ 1/100 to <1/10), infrequently (from ≥ 1/1000 to <1/100), rarely (from ≥ 1/10 000 to <1/1000).

Side effects in the prevention of venous thromboembolism in patients after elective hip or knee arthroplasty:

on the part of the cardiovascular system: infrequently - arterial hypotension (including hypotension during the procedure);
from the blood and lymphatic system: often - anemia (including post-hemorrhagic and postoperative, accompanied by changes in laboratory results), bleeding (including hematoma, vaginal and urethral bleeding); infrequently - thrombocytopenia (including a decrease in the number of platelets);
from the digestive system: often - nausea; infrequently - gastrointestinal bleeding (including melena, vomiting mixed with blood), the presence of unchanged blood in the stool; rarely - bleeding from the gums, rectal bleeding;
from the liver and biliary tract: infrequently - an increase in the activity of transaminases, an increase in the concentration of bilirubin in the blood and the activity of alkaline phosphatase, pathological changes in liver function tests;
from the urinary system: infrequently - hematuria;
from the immune system: rarely - hypersensitivity reactions;
from the musculoskeletal system: rarely - muscle hemorrhage;
from the respiratory system: infrequently - epistaxis; rarely - hemoptysis;
on the part of the organ of vision: rarely - hemorrhages in the tissue of the eyeball (including hemorrhage in the conjunctiva);
others: often - closed injury; infrequently - bleeding during surgery, hemorrhage in the area of the incision (including hematoma in the area of the incision), the presence of discharge from the wound, hemorrhage and bleeding after invasive procedures (including hematoma after the procedure, at the site of the catheter installation and in the area of vessel puncture, bleeding from a postoperative wound).

Side effects in the prevention of strokes and systemic embolism in patients with atrial fibrillation:

on the part of the cardiovascular system: often - bleeding, hematomas; infrequently - bleeding into the abdominal cavity;
from the nervous system: infrequently - spinal and subdural hematomas, intracranial and cerebrospinal canal hemorrhages, subarachnoid hemorrhages;
from the respiratory system: often - nosebleeds; infrequently - hemoptysis; rarely - bleeding into the respiratory system (including pharyngeal, laryngeal and pulmonary alveolar bleeding);
from the immune system: infrequently - hypersensitivity reactions (skin rashes, allergic edema, anaphylactic reactions);
from the digestive system: often - bleeding from the gums, gastrointestinal bleeding, rectal bleeding; infrequently - bleeding into the mouth, the presence of unchanged blood in the stool, hemorrhoidal bleeding; rarely - retroperitoneal (retroperitoneal) hemorrhage;
from the reproductive system: infrequently - urogenital bleeding, intermenstrual vaginal bleeding;
from the urinary system: often - hematuria;
on the part of the organ of vision: often - hemorrhages in the tissue of the eyeball;
others: often - closed injury; infrequently - bleeding after the procedure, traumatic bleeding, hemorrhage in the incision area;
laboratory indicators: infrequently - a positive reaction in the analysis of feces for occult blood.

Side effects in the treatment of deep vein thrombosis and pulmonary embolism:

on the part of the cardiovascular system: often - hematomas; rarely - pericardial bleeding, bleeding into the abdominal cavity, other types of bleeding, hemorrhagic shock;
on the part of the blood and lymphatic system: rarely - sudden formation of hematomas, hemorrhagic diathesis, hemorrhagic anemia;
from the respiratory system: often - nosebleeds; infrequently - hemoptysis; rarely - pulmonary alveolar bleeding;
from the reproductive system: often - hypermenorrhea; infrequently - metrorrhagia, vaginal bleeding; rarely - hematospermia, genital bleeding, uterine bleeding, menometrorrhagia, hemorrhage in the mammary gland, uterine bleeding after menopause;
from the urinary system: often - hematuria; rarely - bleeding from the urinary system;
from the digestive system: often - bleeding from the gums; infrequently - gastrointestinal bleeding, the presence of unchanged blood in the stool, rectal bleeding, bloody vomiting, hemorrhoidal bleeding; rarely - bleeding into the mouth, bleeding in the small intestine, melena, Mallory-Weiss syndrome, hematomas of the abdominal wall, gastric bleeding, bleeding from gastric and duodenal ulcers, anal bleeding;
from the nervous system: rarely - craniocerebral hemorrhage, hemorrhagic stroke;
from the musculoskeletal system: rarely - muscle hemorrhage;
on the part of the organs of hearing and vision: infrequently - hemorrhage into the conjunctiva; rarely - ear bleeding, hemorrhages in the tissue of the eyeball, hemorrhages in the sclera, retina, vitreous;
on the part of the skin: infrequently - bleeding from the skin, bruising; rarely - blood callus, purpura, petechiae, bleeding from skin ulcers, increased tendency to bleed;
others: infrequently - traumatic hematoma, hematoma at the injection / puncture site, bleeding from the wound; rarely - periorbital hematoma, hematoma during and after the procedure, subcutaneous hematoma, extradural hematoma, kidney hematoma, subdural bleeding, bleeding at the injection / infusion site, hematuria after the procedure, vascular pseudoaneurysm;
laboratory indicators: infrequently - a positive reaction in the analysis of feces for occult blood, the presence of blood in the urine; rarely - occult blood, the presence of erythrocytes in the urine.

Overdose

In case of an overdose, no clinically significant side effects were observed, the risk of bleeding increases.

No antidote has been established. The use of hemodialysis is ineffective. In case of an overdose, it is recommended to take activated carbon, if necessary, symptomatic therapy is carried out.

special instructions

Risk of bleeding

For patients with atrial fibrillation and conditions requiring monotherapy or combination therapy of two antiplatelet drugs, Eliquis can be prescribed only after a careful assessment of the balance of benefits and risks.

After acute coronary syndrome in patients with multiple concomitant diseases (including non-cardiac), the risk of bleeding is increased compared with placebo with the simultaneous use of Eliquis and acetylsalicylic acid.

During treatment with apixaban, like any other anticoagulant, it is required to monitor the patient's condition for the development of bleeding. If heavy bleeding occurs, Eliquis is canceled.

Possible options for stopping bleeding include surgical hemostasis and transfusion of fresh frozen plasma. In life-threatening conditions that cannot be controlled by these methods, it is possible to introduce a recombinant coagulation factor VIIa (however, at the moment, there is no experience of its use in patients receiving apixaban).

Surgical and invasive procedures

It is recommended to assess the ratio of the risk of bleeding and the separation of the timing of surgery Eliquis must be canceled at least 48 hours before the upcoming planned invasive procedure or surgery if there is an average or high risk of developing clinically significant bleeding. If there is a low risk of bleeding or bleeding may occur that can be easily controlled, the drug should be discontinued at least 24 hours before the procedure / surgery.

In case of nonvalvular atrial fibrillation within 1–2 days after discontinuation of Eliquis, “bridge therapy” is usually not required before surgery.

After the intervention and achievement of adequate hemostasis, the administration of apixaban should be resumed immediately.

In case of cardioversion, Eliquis can be continued.

Performing spinal, epidural, or puncture

In patients receiving antithrombotic agents for the prevention of thromboembolism, during spinal / epidural puncture / anesthesia, the risk of hematoma formation is increased, which can lead to the development of persistent and irreversible paralysis. This risk increases with the use of an installed epidural catheter in the postoperative period, as well as in the case of the simultaneous use of other drugs that affect hemostasis. In this regard, subarachnoid and epidural catheters should be removed at least 5 hours before taking the first dose of Eliquis.

There is no clinical experience with apixaban in the presence of an installed epidural or intrathecal catheter. If required, the catheter should be removed no earlier than 20-30 hours after the last dose of Eliquis, ie, at least one dose of the drug will have to be skipped before the catheter is removed.

The risk of hematomas leading to the development of paralysis is also increased with traumatic or repeated punctures of the subarachnoid / epidural spaces. In this connection, frequent monitoring of patients is required for the appearance of impaired function of the nervous system, such as weakness in the lower extremities or their numbness, impaired function of the bladder or intestines. In these cases, urgent examination and treatment is required.

Before performing interventions on the subarachnoid / epidural spaces in patients receiving Eliquis, including for the prevention of thrombosis, the ratio of the expected benefits and probable risks should be assessed.

Treatment of deep vein thrombosis and pulmonary embolism

It is not recommended to replace therapy with unfractionated (standard) heparin with Eliquis during the initiation of therapy in patients with PE with unstable hemodynamics, possible thrombolysis or pulmonary thrombectomy.

Influence on the ability to drive vehicles and complex mechanisms

Eliquis components do not have a significant effect on the patient's cognitive and psychomotor functions.

Application during pregnancy and lactation

According to preclinical studies, the drug is not toxic to reproductive function. However, data on the use of Eliquis during pregnancy are limited, so the appointment of the drug is not recommended.

There is no information on the elimination of the drug in breast milk in humans, but in studies on rats it was found that the concentration of apixaban in breast milk is many times higher than the level in blood plasma (about 8 times). This suggests that the drug actively penetrates into breast milk, which is why there is a risk of undesirable effects in infants. In this regard, it is recommended to stop breastfeeding if taking Eliquis is required during lactation.

The effect of apixaban on fertility has not been established in animal studies.

Pediatric use

According to the instructions, Eliquis is not used to treat patients under the age of 18.

With impaired renal function

Eliquis dose adjustment is not required in patients with CC more than 15 ml / min.

Studies on the use of apixaban in patients with CC less than 15 ml / min and patients on dialysis have not been conducted, therefore, the appointment of the drug in this category of patients is not recommended.

For violations of liver function

Eliquis dose adjustment for patients with mild to moderate hepatic impairment is not required, but treatment should be carried out with caution.

It is not recommended to prescribe the drug to patients with severe hepatic impairment.

Use in the elderly

There is no need to adjust the dose of Eliquis in elderly people, except for patients who have atrial fibrillation with two of three criteria.

Drug interactions

Impact of apixaban on the pharmacokinetics of other drugs

In studies in healthy volunteers, apixaban did not have a significant effect on the pharmacokinetics of naproxen, atenolol, digoxin.

In vitro studies have not observed inhibition of the activity of isoenzymes CYP2C9, CYP2B6, CYP3A4, CYP2A6, CYP2D6, CYP2C8, CYP1A2 (inhibitory concentration> 45 μmol / l). However, a weak suppression of CYP2C19 activity (inhibitory concentration> 20 μmol / L) was observed if the level of apixaban significantly exceeds the maximum plasma concentration observed when using the drug in accordance with the recommendations.

At concentrations up to 20 μmol / L, apixaban is not an inducer of CYP3A4 / 5, CYP2B6 and CYP1A2 isoenzymes, therefore, when used together, it will probably not affect the clearance of drugs, in the metabolism of which these isoenzymes are involved.

Apixaban has no significant inhibitory effect on the activity of P-glycoprotein.

The effect of other drugs on the pharmacokinetics of apixaban

Inhibitors of the isoenzyme CYP3A4 and P-glycoprotein can increase the average values of AUC and the maximum concentration of apixaban, therefore, when using them simultaneously, caution should be exercised, no dose adjustment is required.

Inducers of the isoenzyme CYP3A4 and P-glycoprotein can lead to a decrease in the average AUC values of apixaban and its maximum concentration. With combination therapy, dose adjustment of Eliquis is not required, but treatment should be carried out with caution. The exception is when apixaban is prescribed for the treatment of DVT and PE - such patients are not recommended to use the powerful inducers of the CYP3A4 isoenzyme and P-glycoprotein at the same time.

With the combined use of apixaban with enoxaparin, an additive effect on FXa activity is noted.

There were no signs of the interaction of apixaban with acetylsalicylic acid (at a dose of 325 mg 1 time per day) in healthy volunteers. However, in sensitive patients, the likelihood of a more pronounced pharmacokinetic interaction should be considered.

During the period of apixaban therapy, it is not recommended to prescribe drugs that can lead to the development of serious bleeding: vitamin K antagonists and other oral anticoagulants, antagonists of receptors for glycoprotein IIb / IIIa, thrombolytic drugs, dextran, dipyridamole, sulfinpyrazone, unfractionated heparin or including low molecular weight heparins), direct thrombin II inhibitors (for example, desirudin), oligosaccharides that inhibit FXa (for example, fondaparinux). It should be noted that unfractionated heparin can be used at doses that maintain the patency of the venous / arterial catheter. Concomitant use of other antiplatelet agents or other antithrombotic drugs in patients after elective hip / knee arthroplasty is not recommended.

In patients with acute coronary syndrome and numerous concomitant diseases (cardiac or non-cardiac), the risk of bleeding is significantly increased in the case of combined administration of acetylsalicylic acid or triple antithrombotic therapy (use of a combination of apixaban + acetylsalicylic acid + clopidogrel).

In patients with atrial fibrillation, the risk of bleeding is increased with the simultaneous use of one or two antiplatelet agents, so this combination of drugs can be prescribed after evaluating the benefits and risks. During treatment, careful monitoring of the patient's condition is required.

Potent inducers of CYP3A4 and P-glycoprotein (such as St. John's wort, carbamazepine, phenytoin, rifampicin, and phenobarbital) can halve the plasma concentration of apixaban. These combinations should be used with caution. If Eliquis is prescribed for the treatment of DVT or PE, the combined use of potent inducers of CYP3A4 and P-glycoprotein is not recommended.

There was no clinically significant interaction with the simultaneous use of atenolol, famotidine.

Analogs

Eliquis's analogs are Ksarelto, Arikstra.

Terms and conditions of storage

Store at temperatures up to 30 ° C out of reach of children.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Eliquis

According to reviews, Eliquis is an effective anticoagulant agent. It is often prescribed to reduce the risk of systemic thromboembolism and stroke, especially in patients with concomitant chronic heart failure, a history of stroke, and the elderly. Compared with rivaroxaban, warfarin, and vitamin K antagonists, apixaban is significantly less likely to develop bleeding because it blocks only one stage of coagulation. In addition, Eliquis interacts less with other drugs, its doses are easy to adjust, unlike warfarin.

Eliquis is easy to use: patients are prescribed a fixed dose 2 times a day, which eliminates the need for constant laboratory monitoring. This factor is especially important in atrial fibrillation with the appointment of anticoagulants for life to prevent cardioembolic stroke.

Reviews of the drug are mostly positive. Some patients complain of side effects.

One of the complications with apixaban is bleeding. To reduce its risk, it is recommended to carry out antithrombotic therapy in the shortest possible courses.

Price for Eliquis in pharmacies

Approximate prices for Eliquis: 2.5 mg tablets (20 pcs. In a package) - 793-920 rubles, 2.5 mg tablets (60 pcs. In a package) - 2288-2678 rubles, 5 mg tablets (20 pcs. In a package) - 794-868 rubles, 5 mg tablets (60 pcs. In a package) - 2289-2668 rubles.

Eliquis: prices in online pharmacies

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!