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    Overview

    Apixaban is an anticoagulant used for the prophylaxis of stroke and systemic embolism in nonvalvular atrial fibrillation, and deep vein thrombosis (DVT) leading to pulmonary embolism (PE), including in patients after a hip or knee replacement surgery.

    Apixaban is chemically described as 1-(4-methoxyphenyl)-7-oxo-6-[4-(2-oxopiperidin-1-yl)phenyl]-4,5,6,7-tetrahydro-1 H-pyrazolo[3,4- c]pyridine-3- carboxamide. Its molecular formula is C25H25N5O4, which corresponds to a molecular weight of 459.5.

    Apixaban exists as a white to pale yellow powder that is sparingly soluble in N, N-Dimethylformamide and practically insoluble in Water. Its melting point is about 238°C.

    Clinical Applications

    To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
    For the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE) in patients who have undergone hip or knee replacement surgery.
    For the treatment of DVT and PE and for the reduction in the risk of recurrent DVT and PE therapy.

    Mode of Administration

    Apixaban is taken orally in tablet form.

    Pharmacological Effects

    Apixaban is a selective inhibitor of FXa. It does not require antithrombin III for antithrombotic activity. Apixaban inhibits free and clot-bound FXa, and prothrombinase activity. Apixaban has no direct effect on platelet aggregation, but indirectly inhibits platelet aggregation induced by thrombin. By inhibiting FXa, Apixaban decreases thrombin generation and thrombus development.

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