![\"eliquis](\"http:\/\/discoveryrehab.com\/wp-content\/uploads\/2014\/05\/eliquis-Apixaban.png\")
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It is used mainly to prevent harmful blood clots from forming in the blood vessels.<\/p>\n
Eliquis is mostly used to prevent blood clots for people who have had a total hip replacement or knee replacement surgery, for the prevention of venous thromboembolism (blood clots in the veins) and the prevention of stroke in atrial fibrillation.<\/p>\n
Coagulation cascade is a series of reactions, by which, certain protein complex reacts with co-factors and become active components that then catalyze the next reaction in the series to make a bigger complex, ultimately resulting in cross-linked fibrin (blood clot).<\/p>\n
Eliquis prevents an important step in this series of reactions by selectively and reversibly blocking the active site of an enzyme (responsible for activation of Factor X to Factor Xa) without requiring a cofactor (e.g., antithrombin III) and breaks the chain to clot formation.?<\/span><\/p>\n (<\/span>Activation of Factor X to Factor Xa via the intrinsic and extrinsic pathways plays a central role in the blood coagulation)<\/p>\n after the FDA approved the drug. However, Eliquis sales for 2013 could not even reach $129 million marks. While, global sales of PRADAXA?<\/sup> were $875 million and $582 million for XARELTO?<\/sup>. Eliquis and Pradaxa are both better than warfarin in preventing stroke. Only Eliquis, however, reduced major bleeding over warfarin and improved mortality. According to the Bristol-Myers Squibb Reports First Quarter 2014 Financial Results, Global revenues for Eliquis were $106 million.Analysts are forecasting a $9 billion market for new blood thinners and a drug that fit Apixabans efficacy and safety profile could snatch half of that. Leerink Swann’s Seamus Fernandez estimated peak Eliquis sales at $4.2 billion in 2017<\/b><\/p>\n If you?re new to Eliquis you likely have some questions about the drug. So let?s dive into the most important information about this drug.<\/p>\n The primary use of this medicine is for stroke and clot prevention in people with atrial fibrillation.<\/b><\/p>\n The usual dose is 5 mg twice daily (once in the morning and once in the evening, about 12 hours apart).<\/p>\n A reduced dose of 2.5 mg orally twice daily is recommended for patients with 2 or more of the following:<\/p>\n Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.<\/p>\n If a dose is missed, administer the missed dose as soon as possible on the same day and resume twice daily administration. Doses should not be doubled.<\/p>\n Modifying Doses:<\/b><\/p>\n NOTE:<\/b>No data are available in respect of the safety and efficacy of Eliquis in children. Use of Eliquis is not recommended in children.<\/p>\n The amount of this medication needed to result in an overdose\u00a0<\/b>greatly depends on the individual characteristics of the user.<\/p>\n In controlled clinical trials, orally administered Apixaban in healthy subjects at doses up to 50mg daily for 3 to 7 days (25mg twice daily for 7 days or 50mg once daily for 3 days) had no clinically relevant adverse effects.<\/p>\n However, <\/span>Overdose of Eliquis will greatly increase the risk of severe bleeding in patient.<\/p>\n Yes, this medication can cause bleeding which can be serious and rarely may lead to death.<\/p>\n Any?noticeable negative side effect is cause for a medical consultation. These and other symptoms might be signs of an allergy, incompatible drug interactions, or other complications and should be addressed as soon as possible.<\/p>\n If the overdose was recent, a healthcare provider may give certain medicines or place a tube into the stomach to pump the stomach.<\/p>\n In healthy subjects, administration of activated charcoal 2 and 6 hours after ingestion of a 20-mg dose of Apixaban reduced mean drug AUC by 50% and 27%, respectively.<\/p>\n Thus, administration of activated charcoal may be useful in the management of Apixaban overdose or accidental ingestion.<\/p>\n Once Apixaban has been absorbed into the body, there is no treatment that can remove it quickly and so specific antidotes are known. However, not all hope is lost. An investigational new drug is entering the market known as Andexanet alfa<\/b>, which is claimed to be a potential antidote for Factor Xa inhibitors.<\/p>\n But for now, the possibility of multiple drugs is considered to <\/span>manage overdosage.<\/p>\n Call your doctor or get medical help right away if you have any of these signs or symptoms of bleeding when taking Eliquis:<\/b><\/p>\n In the event of hemorrhagic complications, treatment must be discontinued and the source of bleeding investigated. The initiation of appropriate treatment, e.g., surgical hemostasis or the transfusion of fresh frozen plasma should be considered.<\/p>\n NOTE: <\/b>If life-threatening bleeding cannot be controlled by the above measures, administration of recombinant Factor VIIa may be considered. However, there is currently no experience with the use of recombinant Factor VIIa in individuals receiving Apixaban. Re-dosing of recombinant Factor VIIa could be considered and titrated depending on improvement of bleeding. Depending on local availability, a consultation of a coagulation expert should be considered in case of major bleedings.<\/p>\n a.) Adverse drug reactions (ADRs)<\/b> shown to occur with more than 50mg\/day dosage at rate higher than seen with placebo:<\/p>\n Apixaban is a cost-effective alternative to warfarin in warfarin-suitable candidates and also compares well with aspirin<\/b> in patients who cannot take the vitamin K antagonist.<\/p>\n The findings, derived from randomized trial data, were published online February 16, 2014, ahead of print in the European Heart Journal.<\/p>\n According to Dr. Dorian and colleagues, the higher treatment cost for Apixaban was lessened from 2 factors: the price of the drug itself and the additional time patients spent taking it.<\/strong><\/p>\n The choice of an optimal anticoagulant in patients should involve careful consideration of stroke prevention efficacy, bleeding risk, tolerability profile, and resource burden associated with therapeutic management. Our analysis clearly demonstrates that Apixaban, when compared with the current standard of care provides a cost-effective alternative for prevention of thromboembolic events, researchers said.<\/p>\n Drug interactions may change how your medications work or increase your risk for serious side effects. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.<\/p>\n Some products that may interact with this drug include:<\/p>\n Eliquis tablets contain a good quantity of lactose <\/b>and should be taken with caution by people with rare hereditary problems of galactose intolerance, the LAPP lactase deficiency or glucose-galactose malabsorption. Lactose is the main sugar in milk and other dairy products.<\/p>\n Lactose intolerance is not curable.<\/p>\n If you have LI, you might have one or more of these symptoms. They may be mild or severe.<\/p>\n If you have lactose intolerance, you can’t digest lactose because your small intestine doesn’t make enough lactase, the enzyme that digests lactose. The lactose that isn’t digested makes gas in your colon. So when you eat foods or take pills with lactose, you have symptoms.<\/p>\n Even with lactose intolerance, you can tolerate a certain amount of lactose. This affects how quickly you have symptoms and how severe they are. Talk to your doctor if you experience any of these symptoms after taking this medication.<\/p>\n (NOTE: Do not reduce or stop your regimen without the doctors approval and oversight)<\/p>\n Eliquis comes with a Black Box warning regarding its withdrawal.<\/b><\/p>\n Do not stop taking Apixaban without talking to your doctor.<\/p>\n You are at a higher risk of having a stroke after you stop taking Apixaban.<\/p>\n Continue to take Apixaban even if you feel well.<\/p>\n Be sure to refill your prescription before you run out of medication so that you will not miss any doses of Apixaban.<\/p>\n Your doctor may prescribe another anticoagulant or blood thinner,<\/b> if you need to stop taking Apixaban, to help prevent a blood clot from forming and causing you to have a stroke.<\/p>\n a.) Eliquis is pregnancy category <\/b>B<\/b><\/span> drug. <\/b>If you are pregnant or become pregnant while taking Pristiq, you should talk to your doctor about alternative treatments for your condition.<\/p>\n There are no good studies of Apixaban in pregnant women.<\/p>\n Treatment is likely to increase the risk of bleeding during pregnancy and delivery.<\/p>\n Apixaban should be used during pregnancy only if the potential benefit outweighs the potential risk to the mother and unborn baby.<\/p>\n Studies in animals dosed directly with Apixaban have shown no effect on fertility. However, in the female offspring of pregnant rats treated with Apixaban, there were decreases in mating and fertility.<\/p>\n Tell your doctor if you are breastfeeding or plan to breastfeed.<\/p>\n It is unknown whether Apixaban or its metabolites are excreted in human milk.<\/p>\n In lab studies, this drug was found to be excreted in rat?s milk (12% of the maternal dose).<\/p>\n A film coating is a thin polymer-based coat applied to a solid dosage form such as a tablet. The purpose of applying the film coating may be decorative, functional (like easy swallowing, or to prevent the bitter taste while taking the medicine) or both.<\/p>\n 60-tabs\/$314.14 and 100-tabs\/$520.74<\/p>\n Each yellow, round tablet, with “893” marked on one side and “2 ?” on the other side, contains 2.5 mg Apixaban.<\/p>\n 60-tabs\/$314.14 and 100-tabs\/$520.74<\/p>\n Each pink, oval tablet, with “894” marked on one side and “5” on the other side, contains 5 mg Apixaban.<\/p>\n Eliquis? is available as a brand name drug only. A generic version is not yet available. Prices are for cash paying customers only and are not valid with insurance plans. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.<\/p>\n You must inform them f you are having any type of surgery, including oral or dental surgery. Eliquis may cause heavy bleeding during surgery which may be life-threatening.<\/p>\n Apixaban prolongs clotting tests such as prothrombin time (PT), and activated partial thromboplastin time (aPTT). Although Eliquis therapy will lead to an elevated INR, depending on the timing of the measurement, the INR is not a valid measure to assess the anticoagulant activity of Eliquis.<\/p>\n The INR is only calibrated and validated for vitamin K antagonists (VKA) and should not be used for any other anticoagulant, including Eliquis.<\/p>\n Protamine sulfate and vitamin K are considered as antidotes for anticoagulants like warfarin etc. But these would not affect the anticoagulant activity of Apixaban.<\/p>\n Grapefruit juice may increase Apixaban serum concentration and increase your chances of severe bleeding.<\/p>\n 18.) Temporary discontinuations <\/b>of anticoagulants, including Eliquis, for active bleeding, elective surgery, or invasive procedures places patients at an increased risk of thrombosis. Lapses in therapy should be avoided and if anticoagulation with Eliquis must be temporarily discontinued for any reason, therapy should be restarted as soon as possible.<\/p>\n 19.) If you want to switch from Vitamin K antagonist (VKA) therapy to Eliquis?<\/b>your doctor will discontinue warfarin or other VKA therapy and start Apixaban when the international normalized ratio (INR) is less than 2.0.<\/p>\n The half-life of Apixaban is 5-6 hour normally but a patient on repeated dosing will show an apparent half-life of 12 hours.? Eliquis is highly<\/span> protein bound (87%) and NOT dialyzable.<\/p>\n Bristol-Myers Squibb Pharmaceuticals Ltd.<\/p>\n Bristol-Myers Squibb Pharmaceuticals Ltd. and Pfizer Inc.<\/p>\n Inactive ingredients:<\/b><\/p>\n The film coating contains:<\/b><\/p>\n Sources<\/b><\/p>\n 1.) Eliquis (Apixaban)?is a relatively new medication and selective inhibitor. It is used mainly to prevent harmful blood clots from forming in the blood vessels. Eliquis is mostly used to prevent blood clots for people who have had a total hip replacement or knee replacement surgery, for the prevention of venous thromboembolism (blood clots in …<\/p>\nUnlike the previously best known anticoagulant Warfarin<\/b>, Eliquis is far much better because it significantly reduces:<\/h3>\n
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3.) Pfizer predicted first-year sales of $350 million<\/h2>\n
4.) General Instruction for Use<\/b><\/h2>\n
Unlabeled<\/b> Uses:<\/h3>\n
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Reduced Dosages:<\/h3>\n
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What to do concerning Missed Doses?<\/b><\/h3>\n
For Renal impaired patients<\/span><\/h4>\n
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For Hepatic impaired patient<\/span><\/h4>\n
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Administration:<\/b><\/h2>\n
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<\/p>\n5.) Can you Overdose on Eliquis?<\/b><\/h2>\n
Can an overdose of this drug result in death??<\/b><\/h3>\n
In the event of an expected overdose, you or your loved ones should take immediate action and seek medical help.<\/h3>\n
Management of Overdoses will vary<\/b>.<\/h3>\n
6.) Eliquis and Severe Bleeding<\/b><\/h2>\n
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7.) Associated Side effects and Risks<\/h2>\n
Very common Side effects (>10% incidence)?<\/b><\/h3>\n
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Less Common Side effects (1-10% incidence)?<\/b><\/h3>\n
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b.) Contraindications<\/b><\/h3>\n
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c.) Other?Warnings?and?Precautions:<\/b><\/h3>\n
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8.) Apixaban Cost-Effectiveness Compared with Warfarin or Aspirin<\/b><\/h2>\n
9.) Does Eliquis Have Drug Interactions<\/b><\/h2>\n
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10.) Eliquis Black Box Warnings<\/h2>\n
Discontinuing in patients with non-valvular atrial fibrillation:<\/b><\/h3>\n
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Spinal\/epidural hematoma:<\/b><\/h3>\n
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11.) Eliquis and Lactose Intolerance?<\/b><\/h2>\n
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12.) What About Withdrawals from Eliquis?<\/b><\/h2>\n
13.) What About Eliquis and Pregnancy?<\/b><\/h2>\n
b.) Nursing while on this drug is not recommended.<\/b><\/h4>\n
About ELIQUIS Film-coated Tablets<\/h3>\n
Pricing Information:<\/h3>\n
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14.) Your surgeon or anesthesiologist needs to know that you are taking Eliquis<\/b><\/h2>\n
15.) Eliquis and laboratory tests<\/b><\/h2>\n
16.)<\/b>?Reversing anticoagulant effect through conventional drugs<\/b><\/h2>\n
17.) Important! Avoid drinking grapefruit juice when taking this medication?<\/b><\/h2>\n
20.) What is the?half-life of Eliquis?<\/b><\/h2>\n
Manufacturer:<\/b><\/h3>\n
Marketed by:<\/b><\/h3>\n
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