Eliquat
How it works
Inhibits Factor Xa in the intrinsic and extrinsic pathways. Standard VTE prophylaxis in ambulatory mPDAC.
AVERT trial (NEJM 2019) supports apixaban 2.5 mg BD for primary VTE prophylaxis in ambulatory cancer patients with Khorana score ≥ 2 — pancreatic cancer qualifies. Major bleeding HR 2.00 vs placebo — weigh bleeding risk (GI involvement, low platelets) carefully. Fixed dose; no adjustment for renal function until eGFR < 15.
Dosing
Typical doses
- 2.5 mg PO BD
Schedule
- Twice daily morning and eveningfixed
Side Effects
- •Bleeding (minor: bruising, epistaxis, GI bleed)
- •Anemia from occult bleeding
- Major bleeding (ICH, GI bleed >500 mL, retroperitoneal bleed)
Monitoring
- CBC monthly (watch for Hb drop)
- Avoid NSAIDs; use paracetamol for pain
- Counsel on signs of bleeding
Diet & Food Interactions
Cranberry juice
May increase anticoagulant effect — avoid excessive intake