Apixaban is an OAC with a 12- to 24-hour postsurgical initiation window2

The first dose of Apixaban 2.5 mg twice-daily should be taken 12 to 24 hours after surgery2

The first dose of Eliquis® 2.5 mg twice-daily should be taken 12 to 24 hours after surgery1

Apixaban provides reduction in total VTE/all-cause death vs. enoxaparin following total  hip or knee replacement, with comparable rates of bleeding2,3,4

Twice-daily oral Apixaban 2.5 mg demonstrated2,3,4

Twice-daily oral Eliquis® 2.5 mg demonstrated

Use of Apixaban with Epidural Catheters2

There is no clinical experience with the use of Apixaban with indwelling intrathecal or epidural catheters.  Should the need occur:2

  • Based on pharmacokinetic data, a time interval of 20-30 hours (i.e. 2x half-life) between the last dose of Apixaban and catheter withdrawal should elapse
  • At least one dose of Apixaban should be omitted before catheter withdrawal
  • The next dose of Apixaban may be given at least 5 hours after catheter removal 

Indwelling epidural or intrathecal catheters must be removed at least 5 hours prior to the first dose of ELIQUIS®2


Guidance of Eliquis use after epidural catheter withdrawl

BID: twice daily; DVT: deep-vein thrombosis; QD: once daily; SC: subcutaneous; THR: total hip replacement; VTE: venous  thromboembolism.


References: 1 Granger CB, Alexander JH, McMurray JJ, et al. Apixaban  versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981-992. 2. Based on Apixaban LPDELI052021 (Version no. 13), dated 17th June 2021. 3. Lassen MR, Raskob GE, Gallus A, Pineo  G, Chen D, Hornick P; ADVANCE-2 investigators. Apixaban versus enoxaparin for thromboprophylaxis after knee replacement  (ADVANCE-2): a randomized double-blind trial. Lancet. 2010;375(9717):807-815. 4. Lassen MR, Gallus A, Raskob GE, Pineo  G, Chen D, Ramirez LM; ADVANCE-3 Investigators. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement.  N Engl J Med. 2010;363(26):2487-2498.

#Ruff CT, et al. Lancet. 2014;383(9921):955-62, Hur et al, Acta Orthopaedica 2017; 88 (6): 634–641, Cohen AT et al. Adv Ther 2014;31:473-93

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PP-ELI-IND-0967 28-07-2021
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