Medicine Information

Apiban

Name: Apiban
Brand: Apiban
Rating: 4.5 (117 reviews)

Tablet25 mgAnticoagulantsATC: B01AF02

Generic Name

Apixaban

Manufacturer

Incepta Pharmaceuticals

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
apiban 25 mg tablet	৳ 15.00	৳ 150.00

Description

Overview of the medicine

Apixaban is an oral, direct and reversible Factor Xa inhibitor that prevents the conversion of prothrombin to thrombin. It is used to prevent and treat various thromboembolic disorders.

Uses & Indications

Prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF).

Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE).

Prevention of recurrent DVT and PE.

Prophylaxis of DVT, which may lead to PE, in adult patients who have undergone hip or knee replacement surgery.

Dosage

Adults

Standard therapeutic doses for Apixaban are typically 2.5 mg or 5 mg, twice daily, depending on the indication and patient characteristics. A 25 mg dose is significantly higher than usual therapeutic doses and would likely be considered an overdose or for highly specialized, non-standard use not generally recommended.

Elderly

Dosage adjustment may be required based on renal function and other risk factors for bleeding.

Renal_impairment

Dosage adjustments are necessary for severe renal impairment (creatinine clearance <15 mL/min) or patients on dialysis.

How to Take

Oral administration, with or without food. Tablets can be crushed and suspended in water, D5W, or apple juice, or mixed with applesauce.

Mechanism of Action

Apixaban selectively and reversibly inhibits free and clot-bound Factor Xa, and prothrombinase activity. By inhibiting Factor Xa, apixaban decreases thrombin generation and thrombus formation.

Pharmacokinetics

Onset

3-4 hours (anticoagulant effect)

Excretion

Approximately 27% renal, rest via biliary/fecal excretion.

Half life

Approximately 12 hours.

Absorption

Rapidly absorbed, Cmax 3-4 hours. Oral bioavailability ~50%.

Metabolism

Primarily hepatic (CYP3A4/5, O-demethylation, hydroxylation, sulfation).

Side Effects

Contraindications

Active pathological bleeding.
Hypersensitivity to apixaban or any component of the formulation.
Hepatic disease associated with coagulopathy and clinically relevant bleeding risk.

Drug Interactions

Other Anticoagulants/Antiplatelets

Increased risk of bleeding (e.g., warfarin, aspirin, heparin, NSAIDs).

Strong Inducers of CYP3A4 and P-gp

May decrease apixaban exposure and efficacy (e.g., rifampin, phenytoin, carbamazepine, St. John's wort).

Strong Dual Inhibitors of CYP3A4 and P-gp

May increase apixaban exposure and bleeding risk (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir).

Storage

Store below 30°C, away from moisture and light. Keep out of reach of children.

Overdose

Increased risk of bleeding. Management includes activated charcoal if recently ingested, and supportive care. Specific reversal agent (Andexanet alfa) is available.

Pregnancy & Lactation

Pregnancy Category B. Not recommended during breastfeeding due to potential for serious adverse reactions in the breastfed infant.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

Typically 10, 30, or 60 tablets per pack for 2.5mg or 5mg. A 25mg pack size would be unusual for standard therapeutic use.

Shelf Life

Varies by manufacturer, typically 2-3 years.

Availability

Worldwide

Approval Status

Approved (for Apixaban)

Patent Status

Varies by region

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials (e.g., ARISTOTLE, AVERROES, AMPLIFY) have established the efficacy and safety of apixaban at standard doses (2.5 mg, 5 mg) for indicated uses.

Lab Monitoring

No routine coagulation monitoring required. Periodic monitoring of renal function is advisable.
Monitor for signs and symptoms of bleeding.

Doctor Notes

Emphasize bleeding risk and patient education on signs and symptoms of bleeding.
Careful consideration of renal function, body weight, and concomitant medications, especially those affecting hemostasis.
Patients should be advised not to discontinue apixaban without medical advice due to increased risk of thrombotic events.

Patient Guidelines

Take exactly as prescribed and do not skip doses.
Do not stop taking without consulting a doctor due to increased risk of thrombotic events.
Report any signs of unusual bleeding or bruising immediately to your doctor.
Inform all healthcare providers, including dentists, about your apixaban use.

Missed Dose Advice

Take the missed dose as soon as possible, then continue with the next dose at the regularly scheduled time. Do not take a double dose to make up for a missed one.

Driving Precautions

Apixaban is not expected to affect the ability to drive or operate machinery. However, if you experience dizziness or visual disturbances, you should avoid such activities.