Direct Factor Xa Inhibitor

2 Drugs classified under this drug class

Anticoagulant, Direct Factor Xa Inhibitor. Apixaban 2.5 mg, 5 mg.
F.C. TAB: 60 x 2.5mg, 60 x 5mg
Preven. of VTE (VTEp): elective hip or
knee replac. surg.- 2.5 mg ×2/d.
Init. dose should be taken 12 - 24 hrs.
after surg.
In pts. underg. hip replac. surg.- The
recom. duration of tmt. is 32- 38 d.
In pts. underg. knee replac. surg.: The
recom. duration of tmt. is 10- 14 d.
Preven. of stroke & syst. embol. in pts.
with non-valvul. atrial fibril. (NVAF):
5 mg ×2/d.
Dose reduction: 2.5mg×2/d in pts. with
NVAF and at least two of the follow.
characteristics: age ≥ 80 yrs., bdy. wt. ≤
60 kg, or ser. Cr ≥ 1.5 mg/dL (133
micromole/L).
Ther. should be cont. long term.
Tmt. of DVT, tmt. of PE and preven. of
recur. DVT &PE (VTEt)
Tmt. of acute DVT and tmt. of PE is 10
mg×2/d for the first 7 d. follow. by 5
mg ×2/d.
As per avail. med. guidelines, short
durat. of tmt. (at least 3 mnths.) should
be based on transient risk factor. (e.g.
recent surg., trauma, immobilis.).
Preven. of recur. DVT & PE is 2.5
mg×2/d. When preven. of recur. DVT &
PE is indic., the 2.5 mg×2/d should be
init. follow. complet. of 6 mnths. of tmt.
5 mg×2/d or with another anticoag.
See Lit.
2.5 mg tabs. - Preven. of VTE in adult pts.
who have undergone elect. hip or knee
replac. surg.
Preven. of stroke and syst. embol. in adult
pts. NVAF, with one/ more risk fact., e.g as
prior stroke, TIA; age ≥ 75 yrs.; hypertens.;
diabetes. mell.; symptom. HF (NYHA Class
≥ II).
Tmt. of DVT, PE , and preven. of recur.
DVT & PE in adult.
5 mg tabs. - Preven. of stroke, syst. embol.
in adult pts. NVAF, with one/ more risk
fact., e.g. prior stroke or TIA; age ≥ 75 yrs.;
hypertens.; diabetes mell.; symptom. HF
(NYHA Class ≥ II).
Tmt. of DVT, PE in adult. 
C/I: Hypersens.
Active clinic. signific. bleed.
Hep. dis. assoc. with coagulopathy
&clinic. relevant bleed. risk.
Lesion/ condit. if consid. a signific. risk
factor for major bleed. This may include
current or recent GI ulcer., presence of
malig. neoplasm. at high risk of bleed.,
recent brain, spinal inj., recent brain,
spinal or ophthalmic surg., recent
intracran. haemorrhage, known/
suspect. esophagi. varices, arterioven.
malform., vasc. aneurysms or major
intraspinal or intracerebr. vascular
abnorm.
Concom. tmt. with any other anticoag.
agent e.g. unfraction. heparin (UHF), low
molec. wt. heparins (enoxaparin,
dalteparin, etc.), heparin derivat.
(fondaparinux, etc.), oral anticoag.
(warfarin, rivaroxaban, dabigatran, etc.)
except under specific circumstances of
switching anticoag. ther.or when UHF is
given at doses necessary to maintain an
open centr. ven. or arterial catheter.

Direct Factor Xa Inhibitor. Rivaroxaban 2.5 mg.
TABS.: 14, 56, 60, 168
The recomm. dose is 2.5 mg×2/d. Pts. should also take a daily dose of 75 - 100 mg ASA or a dly. dose of 75 - 100 mg ASA in addit. to either a dly. dose of 75 mg clopidogrel. Tmt. should be regularly evaluated in the individ. pt. weighing the risk for ischaem. events against the bleed. risks. Extens. of tmt. beyond 12 mnths. should be done on an individ.pt. Tmt. should be started as soon as possible after stabilisat. of the ACS event (includ. revascularisat. procedures); at the earliest 24 hrs. after admis.to hospital and at the time when parenteral anticoagul. ther. would normally be discont. If a dose is missed the pt. should cont. with the regular dose as recommend. at the next scheduled time. The dose
should not be doubled to make up for a missed dose.
Co-admin. with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel , is indic. for the prevent. atherothrombotic events in adult pts. after an acute coronary syndr. (ACS) with elevated card. biomarkers.
C/I: Hypersens. Active clinical. signific. bleed. Lesion or condit. , if consid. to be a signific. risk for major bleed. This may include current or recent GI ulcerat., presence of malignant neoplasm. at high
risk of bleed., recent brain or spinal injury, recent brain, spinal or ophthalmic surg., recent intracran. haemorrhage, known or suspected oesophageal varices, arterioven. malformat., vascular aneurysms or major intraspin. or intracereb. vascular abnormal. Concom. tmt. with any other anticoagulant.e.g. unfractionat. heparin, low MW hepar. (enoxaparin, dalteparin, etc.), heparin derivatives (fondaparinux,
etc.), oral anticoag. (warfarin, dabigatran etexilate, apixaban, etc.) except under specific circumstan. of switching anticoag. ther. or when UFH is given at doses necessary to maintain an open central venous or arterial catheter. Concom. tmt. of ACS with antiplatelet ther. in pts. with a prior stroke or a TIA. Hep. dis. assoc. with coagulopathy and clinical. relevant bleed.risk include. cirrhotic pts. with Child Pugh B and C.
Pregnancy and breast feeding