This information is intended for healthcare professionals based in Ireland. If you are not a healthcare professional in Ireland, click here

This information is intended for healthcare professionals based in Ireland. If you are not a healthcare professional in Ireland, click here

Dosing considerations for Eliquis® (apixaban) in patients with renal or hepatic impairment

Dosing considerations in patients with impaired renal function

In the absence of additional dose reduction criteria, ELIQUIS does not require a dose adjustment in patients with mild-to-moderate renal impairment.1

Dosing Renal Dosing Renal

Dosing considerations in patients with hepatic impairment across all indications1

Dosing hepatic Dosing hepatic

Prior to initiating ELIQUIS, liver function testing should be performed.1

EHRA recommends that patients with NVAF undergoing treatment with DOACs have blood samples taken yearly to assess haemoglobin, renal function and liver function2

If patients are ≥75 years old or frail,† samples should be taken every 6 months.2 For patients with renal function CrCl ≤60 ml/min, samples should be taken x-monthly, where x = CrCl/10. Renal function should be checked when necessary. Some patients, for example, those with intercurrent conditions that may affect hepatic or renal function, may require more frequent assessments of renal function.2

ELIQUIS is not recommended in patients with CrCl <15 ml/min, or in patients undergoing dialysis.1

ELIQUIS (apixaban) is indicated for prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF), with one or more risk factors, such as prior stroke or transient ischaemic attack (TIA), age ≥75 years, hypertension, diabetes mellitus, symptomatic heart failure (NYHA Class ≥II); treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults; and, prevention of VTE in adult patients who have undergone elective hip or knee replacement surgery.1

Footnotes:

  • † Frailty is defined as three or more criteria of unintentional weight loss, self-reported exhaustion, weakness assessed by handgrip test, slow walking speed/gait apraxia or low physical activity.3
  • ALT = Alanine Aminotransferase   AST = Aspartate Aminotransferase   BD = Twice Daily   CrCl = Creatinine Clearance   DOAC = Direct-Acting Oral Anticoagulant   DVT = Deep Vein Thrombosis   eGFR = Estimated Glomerular Filtration Rate   NVAF = Non-Valvular Atrial Fibrillation   PE = Pulmonary Embolism   ULN = Upper Limit of Normal

References:

  1. ELIQUIS® (apixaban) Summary of Product Characteristics.
  2. Steffel J, Collins R et al. European Society of Cardiology. 2021
  3. Heidbuchel H et al. Europace 2015; 17: 1467–1507

Reporting of suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance at www.hpra.ie

Adverse reactions should also be reported to Bristol-Myers Squibb Medical Information on 1 800 749 749 or medical.information@bms.com