Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

Apixaban (Eliquis, Bristol‑Myers Squibb and Pfizer) is an anticoagulant which directly inhibits factor X (factor Xa), inhibiting thrombin formation and the development of thrombi (blood clots). It is administered orally. To treat deep vein thrombosis (DVT) or pulmonary embolism (PE), 10 mg apixaban should be taken twice a day for the first 7 days, followed by 5 mg twice a day for at least 3 months. For the prevention of recurrent disease, people who have completed 6 months of treatment for DVT or PE should take 2.5 mg twice a day. The summary of product characteristics states that apixaban should be used with caution in people with severe renal impairment.

The most frequent adverse reactions to apixaban are bleeding, bruising, nausea and anaemia. For full details of adverse reactions and contraindications, see the summary of product characteristics.

The cost of apixaban is £1.10 per tablet for either the 2.5 mg or 5 mg dose (excluding VAT; BNF, accessed January 2015). The daily cost of apixaban is £4.40 for the first 7 days followed by £2.20 thereafter. Costs may vary in different settings because of negotiated procurement discounts.