NOACS-Apixaban

Apixaban is an oral anticoagulant and direct inhibitor of factors Xa which is used to decrease the risk of venous thromboses , systemic embolisation and stroke in patients with atrial fibrillation , and lower the risk of deep vein thrombosis and pulmonary embolus after knee or hip replacement surgery ( Pubchem )

Potent oral reversible direct and highly selective inhibitor of factor Xa Inhibits free and clot bound factor Xa and Prothrombinase activity Prevents thrombin generation and thrombus development Apixaban prolongs clotting tests as○ Prothrombin time ( PT )○ INR○ Activated partial thromboplastin time ( aPTT ) Indirectly inhibits platelet aggregation induced by thrombin

Pharmacokinetics-Administered orally and 87 % bound to plasma proteins Rapidly absorbed with max conc appearing 3-4 hrs after tablet intake Can be taken with or without food Multiple routes of elimination Renal excretion accounts for about 27 % of total apixaban clearance Biliary and direct intestinal excretion contribute to fecal elimination Half life about 12 hrs Metabolised mainly via CYP3A4/5 with minor contributions from CY_1A2 ,2C8,2C9,2C19 and 2J2 No impact of impaired renal function on peal concentrations of apixaban

Renal impairment-No impact of impaired renal function on peak concentration of apixaban Apixaban plasma conc ( AUC...