• Reduction of stroke/systemic embolization risk associated with nonvalvular atrial fibrillation (AF).
• Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) following 5–10 days of initial therapy with a parenteral anticoagulant.

Contraindicated in:

• Active bleeding
• CCr >95 mL/min (↓ effectiveness)
• Concurrent use of other anticoagulants or rifampin
• Presence of mechanical heart valves or severe mitral stenosis
• Moderate to severe hepatic impairment
• Triple-positive antiphospholipid syndrome (↑ risk of thrombosis)
• Lactation: Lactation.

Use Cautiously in:

• Elective/planned invasive/surgical procedures (discontinue at least 24 hr prior to ↓ risk of bleeding)
• Premature discontinuation (↑ risk of ischemic events)
• Neuroaxial anesthesia/spinal puncture (↑ risk of spinal/epidural hematoma and potential paralysis)
• Renal impairment (↓ dose for CCr 15–50 mL/min)
• Deteriorating or improving renal function (may require dose change)
• Body weight 60 kg (requires lower dose)
• Women of reproductive potential
• OB: Use during pregnancy only if potential maternal benefit justifies potential fetal risk
• Pedi: Safety and effectiveness not established in children.

GI: ↑liver enzymes.

Hemat: anemia, BLEEDING.

Drug-Drug:

• Rifampin may ↓ levels and effectiveness; concurrent use contraindicated.
• ↑risk of bleeding with other anticoagulants, aspirin, clopidogrel, ticagrelor, prasugrel, fibrinolytics, NSAIDs, SNRIs, or SSRIs.
• P-glycoprotein (P-gp) inhibitors, including azithromycin, clarithromcyin, erythromycin, itraconazole (oral), ketoconazole (oral), quinidine, or verapamil, ↑ levels and the risk of bleeding; lower dose required.

• Tablets: 15 mg; 30 mg; 60 mg;

Treatment of Nonvalvular Atrial Fibrillation

• PO (Adults): 60 mg once daily.

Treatment of Deep Vein Thrombosis/Pulmonary Embolism

• PO (Adults >60 kg): 60 mg once daily. Concurrent use of P-gp inhibitors (verapamil, quinidine, azithromycin, clarithromycin, erythromycin, itraconazole [PO], or ketoconazole [PO]): 30 mg once daily.
• PO (Adults 60 kg): 30 mg once daily.

Savaysa

• Selective inhibitor of factor Xa. Does not inhibit platelet aggregation directly, but does inhibit thrombin-induced platelet aggregation. Decreases thrombin generation and thrombus development.

• Decreased thrombotic events associated with AF, including stroke and systemic embolization.
• Resolution of DVT and PE.

Therapeutic Classification: anticoagulants

Pharmacologic Classification:

Absorption: 62% absorbed following oral administration.

Distribution: Widely distributed to tissues.

Metabolism/Excretion: Minimal metabolism; one metabolite is pharmacologically active. Excreted mostly unchanged in urine.

Half-life: 10–14 hr.

Lixiana

(anticoagulant effect)

• Instruct patient to take edoxaban as directed. Take missed doses as soon as remembered on same day. Return to regular schedule next day. Do not double doses in one day. Do not discontinue without consulting health care professional; stopping may increase risk of stroke. Advise patient to read Medication Guide before starting therapy and with each Rx refill in case of changes.
• Caution patient that they may bleed more easily, longer, or bruise more easily during therapy. Advise patient to notify health care professional immediately if bleeding or a fall, especially with head injury, occurs.
• Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications, especially other aspirin or NSAIDs.
• Advise patient to notify health care professional of therapy before surgery, medical, or dental procedures are scheduled.
• Advise female patient to notify health care professional if pregnancy is planned or suspected and to avoid breastfeeding during therapy. May ↑ risk of uterine bleeding in females of reproductive potential and those with abnormal uterine bleeding. Monitor neonates for bleeding.

e-DOX-a-ban