Uses

Indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, and for the treatment of deep vein thrombosis and pulmonary embolism following initial parenteral anticoagulation. Not recommended in NVAF patients with creatinine clearance greater than 95 mL/min due to increased ischemic stroke risk.

Do not use if

Contraindicated in patients with active pathological bleeding.

Side effects

Bleeding is the most common and serious adverse effect, including major and minor hemorrhage. Other reactions include anemia, rash, and abnormal liver function tests. Abrupt discontinuation in atrial fibrillation patients increases the risk of ischemic stroke.

Warnings

Premature discontinuation in NVAF patients increases ischemic stroke risk; transition to alternative anticoagulant if stopping. Risk of spinal or epidural hematoma with neuraxial anesthesia or puncture; monitor for neurological impairment. Avoid in patients with CrCL greater than 95 mL/min due to reduced efficacy.

How it works

Edoxaban is a selective inhibitor of activated factor Xa (FXa). It does not require antithrombin III for activity. By inhibiting free FXa and prothrombinase, it reduces thrombin generation and inhibits thrombus formation without directly inhibiting thrombin.

Storage

Store at controlled room temperature, 20–25°C (68–77°F); excursions permitted to 15–30°C (59–86°F). Keep out of reach of children.