Mahmoud Hashem: Apixaban – Doses According to the Reason for Use
Mahmoud Hashem, Cardiology and Internal Medicine Consultant, shared a post on X:
“Apixaban (Eliquis) — Doses According to the Reason for Use
One of the most common mistakes in prescribing Apixaban is using the same dose for all patients.
The dose depends first on the reason for using the medication, then on some of the patient’s characteristics.
1. Acute Treatment of DVT or PE
- First 7 days: 10 mg twice daily
- After the first 7 days: 5 mg twice daily
- For extended prevention of recurrent DVT or PE after completing at least 6 months of treatment: 2.5 mg twice daily
2. Non-Valvular Atrial Fibrillation (NVAF)
- The usual dose: 5 mg twice daily
And it is reduced to 2.5 mg twice daily if the patient has two or more of the following three criteria:
- Age 80 years or older
- Weight 60 kg or less
- Serum creatinine 1.5 mg/dL or higher
Very important:
Having only one criterion is usually not sufficient to reduce the Apixaban dose in atrial fibrillation.
Quick Summary:
- DVT or PE: 10 mg BID for 7 days, followed by 5 mg BID, then after 6 months or longer, 2.5 mg BID can be used for extended prevention.
- NVAF: 5 mg BID, then 2.5 mg BID if 2 of 3 criteria are met.
Choosing the DOAC dose is not just about memorizing doses; the dose must be linked to the indication, kidney function, age, weight, and bleeding risk.”
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