Therapeutic Classification: anticoagulants
Pharmacologic Classification: factor xa inhibitors
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 CYP3A4 and P-gp inhibitors: 2.5 mg twice daily; if patient already taking 2.5 mg twice daily, avoid concurrent use.
Renal Impairment
- PO (Adults ): Hemodialysis: 5 mg twice daily; Hemodialysis 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 CYP3A4 and P-gp inhibitors: Avoid concurrent 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 CYP3A4 and P-gp inhibitors: 2.5 mg twice daily
- PO (Children ≥35 kg): 10 mg twice daily for 7 days; then 5 mg twice daily.
- PO (Children 25–<35 kg): 8 mg twice daily for 7 days; then 4 mg twice daily.
- PO (Children 18–<25 kg): 6 mg twice daily for 7 days; then 3 mg twice daily.
- PO (Children 12–<18 kg): 4 mg twice daily for 7 days; then 2 mg twice daily.
- PO (Children 9–<12 kg): 3 mg twice daily for 7 days; then 1.5 mg twice daily.
- PO (Children 6–<9 kg): 2 mg twice daily for 7 days; then 1 mg twice daily.
- PO (Children 4–<6 kg): 1 mg twice daily for 7 days; then 0.5 mg twice daily.
- PO (Children 2.6–<4 kg): 0.3 mg twice daily for 7 days; then 0.15 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 CYP3A4 and P-gp inhibitors: Avoid concurrent use.
