Drug reference

Edoxaban

Anticoagulant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

Antiplatelet AgentsSevereTextbookG&G 14e
Nonsteroidal Anti Inflammatory AgentsSevereTextbookG&G 14e
AbciximabSevereDatabaseDDInter
AbirateroneSevereDatabaseDDInter

Mechanism

Edoxaban is a direct and reversible inhibitor of activated factor X (factor Xa). This action prevents the conversion of prothrombin to thrombin. By prolonging clotting time, Edoxaban reduces the risk of thrombus formation.

Indications

Prophylaxis of stroke and systemic embolism in non-valvular atrial fibrillation, in patients with at least one risk factor (such as congestive heart failure, hypertension, aged 75 years and over, diabetes mellitus, previous stroke or transient ischaemic attack)Treatment of deep-vein thrombosisProphylaxis of recurrent deep-vein thrombosisTreatment of pulmonary embolismProphylaxis of recurrent pulmonary embolismStroke prevention in patients with atrial fibrillationTreatment of acute deep vein thrombosis (started only after a minimum 5-day course of treatment with heparin, LMWH, or fondaparinux)Treatment of pulmonary embolism (started only after a minimum 5-day course of treatment with heparin, LMWH, or fondaparinux)Treatment of cancer-associated venous thromboembolismtreatment of acute venous thromboembolism (after at least 5 days of parenteral anticoagulation)secondary prevention of venous thromboembolismprevention of stroke in atrial fibrillationStroke prevention for atrial fibrillationConcomitant treatment after PCI (e.g., in patients with atrial fibrillation)VTE (after 5 days of parenteral anticoagulation)VTE with cancer (endorsed by NCCN guidelines)

Dosing

Adult: For prophylaxis of stroke and systemic embolism in non-valvular atrial fibrillation: Adult (body-weight up to 61 kg): 30 mg once daily; Adult (body-weight 61 kg and above): 60 mg once daily.…
Renal adjustment: Reduced from 60 to 30 mg once daily in patients with a creatinine clearance between 15 and 50 mL/min. Contraindicated in those with a creatinine clearance below 15 mL/min.
Max dose: 30 mg once daily with concurrent ciclosporin, dronedarone, erythromycin, or ketoconazole.

Pharmacokinetics

Peak effect

1 to 2 h after ingestion

Bioavailability

62%

Protein binding

55% protein bound

Metabolism

minimal hepatic metabolism

Excretion

about 50% eliminated as unchanged drug in the urine

Contraindications

Pulmonary embolism in patients with haemodynamic instability
Pulmonary embolism in patients who may receive thrombolysis or pulmonary embolectomy
creatinine clearance below 15 mL/min
creatinine clearance over 95 mL/min (in the U.S. for stroke prevention in atrial fibrillation, due to higher risk of ischemic stroke than with warfarin)
stroke prevention in patients with mechanical heart valves
patients with antiphospholipid syndrome

Side effects

Common

BleedingDyspepsia (rare)

Serious

Bleeding
More bleeding in patients with intact gastrointestinal cancers (particularly those of the upper gastrointestinal tract) when used for cancer-associated venous thromboembolism
gastrointestinal bleeding (higher rates than warfarin)
intracranial bleeding (at least 50% lower than warfarin)
Intracranial bleeding (less than warfarin)
Gastrointestinal bleeding (higher dose regimens)