edoxaban

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)
Rep: 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.

Adv. Reactions/Side Effects ⬆ ⬇

GI: ↑ liver enzymes.

Hemat: anemia, BLEEDING.

Interactions ⬆ ⬇

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.

Availability ⬆ ⬇

Tablets: 15 mg; 30 mg; 60 mg;

Route/Dosage ⬆ ⬇

Treatment of Nonvalvular Atrial Fibrillation

PO (Adults): 60 mg once daily.

Renal Impairment

PO (Adults): CCr 15–50 mL/min: 30 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.

Renal Impairment

PO (Adults): CCr 15–50 mL/min: 30 mg once daily.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

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

Therapeutic Effects:

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

Classifications ⬆ ⬇

Therapeutic Classification: anticoagulants

Pharmacologic Classification:

Pharmacokinetics ⬆ ⬇

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.

Canadian Brand Names ⬆ ⬇

Time/Action Profile ⬆ ⬇

(anticoagulant effect)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	1–2 hr	24 hr

Patient/Family Teaching ⬆ ⬇

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.
Rep: 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.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code^*

65597- Daiichi Sankyo Inc.
65597-201- SAVAYSA 65597-201-07- 7 TABLET, FILM COATED in 1 BOTTLE (65597-201-07)

65597- Daiichi Sankyo Inc.
65597-201- SAVAYSA 65597-201-10- 10 TABLET, FILM COATED in 1 BLISTER PACK (65597-201-10)

65597- Daiichi Sankyo Inc.
65597-201- SAVAYSA 65597-201-30- 30 TABLET, FILM COATED in 1 BOTTLE (65597-201-30)

65597- Daiichi Sankyo Inc.
65597-201- SAVAYSA 65597-201-50- 500 TABLET, FILM COATED in 1 BOTTLE (65597-201-50)

65597- Daiichi Sankyo Inc.
65597-201- SAVAYSA 65597-201-70- 7 TABLET, FILM COATED in 1 BLISTER PACK (65597-201-70)

65597- Daiichi Sankyo Inc.
65597-201- SAVAYSA 65597-201-90- 90 TABLET, FILM COATED in 1 BOTTLE (65597-201-90)

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-05- 50 BLISTER PACK in 1 CARTON (65597-202-05) > 1 TABLET, FILM COATED in 1 BLISTER PACK

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-07- 7 TABLET, FILM COATED in 1 BOTTLE (65597-202-07)

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-10- 100 BLISTER PACK in 1 CARTON (65597-202-10) > 1 TABLET, FILM COATED in 1 BLISTER PACK

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-30- 30 TABLET, FILM COATED in 1 BOTTLE (65597-202-30)

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-50- 500 TABLET, FILM COATED in 1 BOTTLE (65597-202-50)

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-70- 7 TABLET, FILM COATED in 1 BLISTER PACK (65597-202-70)

65597- Daiichi Sankyo Inc.
65597-202- SAVAYSA 65597-202-90- 90 TABLET, FILM COATED in 1 BOTTLE (65597-202-90)

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-05- 50 BLISTER PACK in 1 CARTON (65597-203-05) > 1 TABLET, FILM COATED in 1 BLISTER PACK

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-07- 7 TABLET, FILM COATED in 1 BOTTLE (65597-203-07)

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-10- 100 BLISTER PACK in 1 CARTON (65597-203-10) > 1 TABLET, FILM COATED in 1 BLISTER PACK

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-30- 30 TABLET, FILM COATED in 1 BOTTLE (65597-203-30)

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-50- 500 TABLET, FILM COATED in 1 BOTTLE (65597-203-50)

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-70- 7 TABLET, FILM COATED in 1 BLISTER PACK (65597-203-70)

65597- Daiichi Sankyo Inc.
65597-203- SAVAYSA 65597-203-90- 90 TABLET, FILM COATED in 1 BOTTLE (65597-203-90)

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Indications ⬇

Contraind./Precautions ⬆ ⬇