Apixaban

Apixaban

Apixaban is a direct factor Xa inhibitor. It has an oral bioavailability of about fifty percent. Peak plasma Levels are achieved in three hours and the half-life is about 12 hours. The drug is metabolized in liver via CYP3A4 and other CYP independent mechanisms. It is eliminated via multiple pathways and no laboratory monitoring required during therapeutic administration. The utility of the drug in preventing stroke in nonvalvular atrial fibrillation has been evaluated in two trial. ARISTOTLE compared apixaban with warfarin and found that it reduces stroke without an increase in bleeds. AVERROES trial compared apixaban with aspirin in those in whom vitamin K antagonists were not usable as in those who were unwilling or unable to monitor INR (international normalized ratio of prothrombin time). In this study also, apixaban reduced stroke without increasing major bleeds.