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Edoxaban vs. Apixaban

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson compares and contrasts the many similarities and differences between medications known as edoxaban and apixaban. You'll learn their indications, side effects, and pregnancy risk categories.

A Deadly Flight

The next time you are on a long flight, consider this. There is the possibility that all that sitting in those terribly cramped seats is going to kill you. No, seriously. Prolonged sitting can lead to the formation of blood clots in the deep veins of your legs, something known as deep vein thrombosis. A piece of this blood clot can then break off and travel to the lungs, causing difficulty in breathing. The latter situation is called pulmonary embolism. Pulmonary embolism can lead to a person's death.

Deep vein thrombosis and pulmonary embolism are related to edoxaban and apixaban, the two drugs we'll be comparing and contrasting in this lesson.

Names & Indications

Edoxaban is the generic term for Savayasa, while apixaban is the generic name for Eliquis. Both medications are indicated to treat or prevent:

  • Deep vein thrombosis (DVT)
  • Pulmonary embolism (PE)
  • Complications from nonvalvular atrial fibrillation

In the latter case, they don't really treat the arrhythmia itself. Instead, they minimize the chances that a person with nonvalvular atrial fibrillation may have a stroke or another blood clot somewhere in his or her body. This is because this arrhythmia predisposes someone to the formation of blood clots in the chambers of the heart, which can then travel to the brain and lead to a stroke.

There's one catch, however. Edoxaban shouldn't be used in people with CrCl > 95 mL/minute. This is because, in such instances, the efficacy of edoxaban is reduced. CrCl stands for creatinine clearance, which is a measure of how well the kidneys remove a waste product, called creatinine, out of the blood (and into urine) and thus how well they filter blood in general.

Pharmacology

Mechanism of Action

How do these medications treat or prevent these conditions? Well, they are both anticoagulants. An anticoagulant is a type of blood thinner. More specifically, they are both factor Xa inhibitors, meaning they stop the action of an enzyme called factor Xa, one that is important for the formation of blood clots. As a result, a factor Xa inhibitor makes it less likely the blood will clot.

Administration & Time to Peak

Both of these medications come as oral tablets. They can be given with or without food. It takes apixaban about three to four hours to peak in the blood, while it takes edoxaban about one to two hours to peak in the blood.

Warnings & Adverse Reactions

Neither medication should be given in the following instances:

  • A known hypersensitivity (allergy) to the medication
  • A person who has active pathological (abnormal and potentially dangerous) bleeding

Both medications can lead to abnormal bleeding events. Apixaban has upwards of a 12% chance of leading to abnormal bleeding, while edoxaban has upwards of a 22% chance of doing so.

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