Therapeutic Classification: anticoagulants
Pharmacologic Classification:
Absorption: 50% absorbed following oral administration.
Distribution: Unknown.
Metabolism/Excretion: Primarily metabolized by the liver by the CYP3A4 isoenzyme; excreted in urine and feces. Biliary and direct intestinal excretion account for fecal elimination.
Half-life: 6 hr (12 hr after repeated dosing due to prolonged absorption).
Reduction in Risk of Stroke/Systemic Embolism in Nonvalvular Atrial Fibrillation
- PO (Adults): 5 mg twice daily; Any 2 of the following: age ≥80 yr, weight ≤60 kg, serum creatinine ≥1.5 mg/dL: 2.5 mg twice daily; Concurrent use of strong inhibitors of both CYP3A4 and P-gp: 2.5 mg twice daily; if patient already taking 2.5 mg twice daily, avoid concomitant use.
Renal Impairment
- PO (Adults): Hemodialysis: 5 mg twice daily; HD and either age ≥80 yr or weight ≤60 kg: 2.5 mg twice daily.
Prevention of Deep Vein Thrombosis Following Knee or Hip Replacement Surgery
- PO (Adults): 2.5 mg twice daily, initiated 12–24 hr postoperatively (when hemostasis is achieved) continued for 35 days after hip replacement or 12 days after knee replacement; Concurrent use of strong inhibitors of both CYP3A4 and P-gp: Avoid concomitant use.
Treatment of Deep Vein Thrombosis or Pulmonary Embolism
- PO (Adults): 10 mg twice daily for 7 days, then 5 mg twice daily; Concurrent use of strong inhibitors of both CYP3A4 and P-gp: 2.5 mg twice daily.
Reduction in Risk of Recurrence of Deep Vein Thrombosis or Pulmonary Embolism
- PO (Adults): 2.5 mg twice daily after ≥6 mo of treatment of DVT or PE; Concurrent use of strong inhibitors of both CYP3A4 and P-gp: Avoid concomitant use.
