✅ Product Benefits

• Effective anticoagulation with convenience: Acts via selective and reversible inhibition of factor Xa to prevent thrombin formation, reducing stroke and systemic embolism risk in non-valvular atrial fibrillation. No routine INR monitoring required. 

• Prophylaxis after orthopedic surgeries: Standard 2.5 mg twice-daily dosing started within 12–24 hours post–hip or knee replacement, offering effective VTE prevention. 

• Flexible dosage for high-risk groups: Dosage reduced to 2.5 mg twice daily in adults meeting at least two criteria: age ≥ 80 years, body weight ≤ 60 kg, or serum creatinine ≥ 1.5 mg/dL. 

• Affordable & locally produced: Priced at ৳ 10 per tablet; ৳ 300 per pack of 30 (3 strips × 10) in Bangladesh. Widely available in pharmacies. 

ℹ️ Indications & Dosing Guide

Approved Uses:

• Stroke/systemic embolism prevention in non-valvular atrial fibrillation

• DVT/PE treatment and prevention of recurrence

• VTE prophylaxis following hip or knee replacement surgery 

Recommended Dosage:

Administration:

• Swallow whole, with or without food, at the same times daily

• Do not break, crush, or chew the tablet

• If missed, take as soon as possible on the same day; do not double dose 

⚠️ Safety & Precautions

• Bleeding risk: Increased risk of hemorrhage; report any unusual bleeding (e.g. blood in stools, urine, brusing gums) immediately. 

• Drug interactions: Strong dual inhibitors of CYP3A4 and P-gp (e.g., ketoconazole, ritonavir, clarithromycin) increase bleeding risk—dose reduction to 2.5 mg twice daily advised. Inducers may reduce effectiveness and raise stroke risk. Co-administration with other anticoagulants or NSAIDs increases bleeding propensity. 

• Contraindications: Active major bleeding, severe hepatic impairment with coagulopathy, hypersensitivity. Use caution in patients with low body weight, renal impairment, or undergoing spinal/epidural puncture. 

• Renal/hepatic impairment:

  • Renal: Mild-to-moderate no adjustment; ESRD/dialysis: use same dose except when ≥2 risk criteria present → reduce to 2.5 mg BID

  • Hepatic: Not recommended in severe impairment; no adjustment in mild-to-moderate. 

• Pregnancy & breastfeeding: Limited data—use only if benefits clearly outweigh risks. May increase peripartum hemorrhage. Caution advised while breastfeeding. 

• Monitoring: Routine coagulation tests not needed. Discontinue 24–48 hours before surgery based on bleeding risk. Switching from/to warfarin requires careful transition protocols. 

📝 Quick Reference

✅ Summary

Apixan 2.5 mg Tablet is a cost-effective, locally manufactured anticoagulant for stroke prevention and VTE management. It delivers convenience without frequent lab monitoring, but demands adherence and awareness of bleeding risks.