APIGAT 5MG TABLETS
Manufactured By Natco Pharma Limited
Composition Apixaban 5mg
RS 681.33
MRP RS 801.56
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Description:
Apigat 5mg Tablet (Apixaban 5mg) is a direct oral anticoagulant (DOAC) belonging to the class of Factor Xa inhibitors, manufactured by Natco Pharma Ltd. and used to prevent and treat life-threatening blood clots in adults. It is the standard therapeutic dose prescribed to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (irregular heartbeat), and to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) — dangerous conditions where clots form in the legs or lungs. It is also used during the initial acute treatment phase of DVT and PE (as 10mg twice daily for 7 days followed by 5mg twice daily), and after hip or knee replacement surgery. Available from Shabbir Medical Hall at the best price in India, this genuine prescription medicine is easy to order online with fast home delivery.
BENEFITS: Apigat 5mg works by selectively and reversibly inhibiting Factor Xa — the pivotal enzyme at the convergence of the intrinsic and extrinsic coagulation pathways — preventing the conversion of prothrombin to thrombin and ultimately stopping fibrin clot formation. Unlike warfarin, Apigat 5mg requires no routine blood monitoring (no INR/PT testing), offers predictable pharmacokinetics with fixed twice-daily dosing, has fewer food interactions, and has a faster onset of action (peak plasma concentration in 3–4 hours). It is one of the most widely prescribed DOACs globally for stroke prevention in AF patients.
USAGE OVERVIEW: Take Apigat 5mg exactly as prescribed by your cardiologist or physician. For atrial fibrillation (standard dose): 5mg twice daily. For acute DVT/PE treatment: 10mg twice daily for 7 days, then 5mg twice daily. Swallow tablets whole with or without food at the same times each day. Never stop treatment without medical advice — abrupt discontinuation dramatically increases the risk of stroke and clot recurrence.
SAFETY OVERVIEW: The most common side effect is an increased tendency to bleed (bruising, nosebleeds, prolonged bleeding from cuts). Serious bleeding episodes (blood in stools or urine, coughing up blood, sudden severe headache) require immediate emergency medical attention. Inform your doctor about all current medications, liver/kidney status, and pregnancy before starting therapy.
Uses / Indications:
• Non-valvular Atrial Fibrillation (AF) — standard 5mg twice daily dose for stroke and systemic embolism prevention in patients at risk (most AF patients)
• Acute Treatment of Deep Vein Thrombosis (DVT) — 10mg twice daily for 7 days, then 5mg twice daily
• Acute Treatment of Pulmonary Embolism (PE) — 10mg twice daily for 7 days, then 5mg twice daily
• Prevention of Recurrent DVT and PE — after initial treatment, 5mg twice daily (followed by 2.5mg twice daily for extended prevention)
• Prevention of VTE after elective hip replacement surgery — 2.5mg twice daily (note: 5mg tablets can be split protocol-dependent on prescriber)
• Prevention of VTE after elective knee replacement surgery
ADDITIONAL USES:
• Secondary cardiovascular event prevention in selected high-risk patients
• Venous thromboembolism (VTE) prophylaxis in cancer-associated thrombosis (emerging clinical protocols)
• Bridge therapy management during procedures in selected anticoagulation protocols
Interactions / Warnings:
LIVER DISEASE: Apigat 5mg is NOT recommended in patients with severe hepatic impairment or liver disease associated with coagulopathy (increased risk of bleeding). Use with caution and medical monitoring in mild to moderate liver disease.
KIDNEY DISEASE: Apixaban is partially renally eliminated (~27%). Use with caution in patients with moderate to severe CKD. Not recommended in patients with severe renal impairment (CrCl <15 ml/min) or on dialysis. Periodic renal function monitoring recommended during long-term therapy.
HEART CONDITIONS: Apigat 5mg is the standard anticoagulant dose for AF stroke prevention — replacing warfarin in most non-valvular AF cases. Do NOT use in patients with prosthetic (mechanical) heart valves — warfarin remains the standard of care. Not recommended in patients with antiphospholipid syndrome.
SURGICAL / SPINAL PROCEDURES: Inform all surgeons, anaesthetists, and dentists that you are taking Apixaban before any procedure. Spinal or epidural anaesthesia while on Apigat carries risk of spinal haematoma — may cause long-term or permanent paralysis. Plan carefully with your medical team.
ALLERGY WARNING: Do not use if you are allergic to Apixaban or any inactive ingredients. Signs of hypersensitivity include rash, facial swelling, difficulty breathing.
ELDERLY USE (≥75 years): Elderly patients are at higher bleeding risk. Those meeting dose-reduction criteria (age ≥80, weight ≤60kg, creatinine ≥1.5mg/dL — any two) should use Apigat 2.5mg instead.
PAEDIATRIC USE: Not recommended for children and adolescents under 18 years of age.
DRIVING & MACHINERY: Apigat is not expected to affect driving ability, but patients should monitor for dizziness or weakness from anaemia or hypotension before driving.
Pregnancy interaction:
• Apigat 5mg (Apixaban) is NOT recommended during pregnancy.
• Animal studies suggest potential fetal harm — possible haemorrhage risk to the unborn baby.
• A pregnancy test may be conducted before initiating treatment.
• Women of childbearing potential should use effective, reliable contraception during treatment.
• Discontinue use and consult your doctor immediately if pregnancy is confirmed during therapy.
• Continue contraception for at least 2 weeks after the last dose.
BREASTFEEDING:
• It is not known whether Apixaban passes into human breast milk.
• Breastfeeding is NOT recommended during treatment as a precautionary measure.
• Discuss alternative infant feeding options with your doctor before starting Apigat.
CONTRACEPTION WARNING / CRITICAL CLINICAL WARNING:
• NEVER stop Apigat 5mg abruptly without consulting your cardiologist or physician.
• Premature discontinuation significantly and rapidly increases the risk of stroke, DVT, and PE — especially in AF patients. Any planned interruption (e.g., before surgery) must be medically supervised.
Expert advice:
1. NEVER STOP ABRUPTLY
• This is the most critical safety rule for Apigat 5mg. Stopping suddenly, even for a day or two, significantly raises your risk of stroke or clot recurrence — especially if you have atrial fibrillation. Always consult your cardiologist before pausing or stopping treatment.
2. TAKE TWICE DAILY — CONSISTENTLY
• Set two alarms 12 hours apart (e.g., 8 AM and 8 PM). Unlike once-daily anticoagulants, Apigat 5mg works on a 12-hour cycle. Missing doses disrupts anticoagulant protection.
3. NO ROUTINE BLOOD TESTS NEEDED
• A key advantage of Apigat over warfarin is that regular INR/PT tests are not required. However, your doctor will still periodically check kidney and liver function — attend all scheduled follow-ups.
4. CARRY AN ANTICOAGULANT ALERT CARD
• Always inform healthcare providers (doctors, dentists, emergency rooms, surgeons) that you are on Apixaban. Carry a medication card or wear a medical ID bracelet for emergencies.
5. REPORT ALL MEDICINES AND SUPPLEMENTS
• Many common medicines (including OTC painkillers, antifungals, antibiotics, and herbal supplements) interact dangerously with Apixaban. Always declare Apigat to any prescriber.
MONITORING ADVICE:
• Kidney function (serum creatinine / eGFR): At baseline and at least annually — renal impairment can elevate Apixaban levels and bleed risk.
• Liver function tests (LFTs): Baseline and if symptoms of liver disease appear.
• Full Blood Count (FBC/CBC): If anaemia is suspected (fatigue, pallor, breathlessness).
• Blood pressure monitoring: Uncontrolled hypertension amplifies stroke risk even on anticoagulant therapy.
• Renal monitoring more frequently in elderly or patients with pre-existing CKD.
COMPLIANCE TIPS:
• Use a twice-daily pill organiser or smart pill dispenser to avoid missed doses.
• Store strips in original child-proof packaging in a cool, dry location.
• Do not share your prescription medicine with others, even with the same condition.
• Do not take OTC NSAIDs (ibuprofen, aspirin for pain) without checking with your pharmacist — serious bleeding risk.
• Keep all cardiology/physician appointments even if you feel well — Apigat is a lifelong treatment for many AF patients.
SAFETY TIPS:
• Use a soft-bristle toothbrush and electric razor to reduce minor bleeding incidents.
• Avoid contact sports, high-impact activities, or situations with high injury risk.
• If a cut does not stop bleeding within 10 minutes of firm direct pressure, seek medical attention.
• Dispose of unused tablets via a pharmacy take-back programme — do not flush or bin them.
• If you require emergency surgery, your medical team can use Andexanet alfa (the approved Apixaban reversal agent) to rapidly neutralise its effect if needed.
Side Effects:
• Increased tendency to bleed — bruising, nosebleeds, bleeding gums, prolonged bleeding from minor cuts
• Anaemia (low red blood cell count) — fatigue, pallor, shortness of breath, weakness
• Haematoma (blood pooling under the skin — visible bruising/swelling)
• Nausea, indigestion, or stomach discomfort
• Mild dizziness or low blood pressure (hypotension)
• Skin rash or itching
SERIOUS SIDE EFFECTS (contact your doctor immediately):
• Major bleeding — blood in vomit, black/tarry stools, blood in urine (pink/red/brown)
• Coughing or spitting up blood
• Intracranial / spinal bleeding — sudden severe headache, vision changes, confusion, numbness, paralysis
• Retroperitoneal or intra-abdominal bleeding — persistent severe abdominal or back pain
• Unusual or excessive bruising, heavy or unexpected vaginal bleeding
• Spinal/epidural haematoma (if used around spinal procedures) — numbness, tingling, weakness in legs
EMERGENCY WARNING SIGNS — SEEK IMMEDIATE MEDICAL HELP:
• Sudden severe headache unlike any before (possible intracranial bleed)
• Fainting, extreme weakness, or confusion
• Swelling of the face, lips, tongue, or throat (anaphylaxis/severe allergic reaction)
• Signs of liver damage: yellowing of skin/eyes (jaundice), dark urine, persistent vomiting
• Signs of overdose: unusual bleeding from multiple sites simultaneously
How to use:
• Non-valvular Atrial Fibrillation (standard dose): 5mg TWICE daily
• Atrial Fibrillation with dose-reduction criteria (any 2 of: age ≥80, weight ≤60kg, creatinine ≥1.5mg/dL): 2.5mg twice daily (use Apigat 2.5mg)
• Acute DVT / PE Treatment (first 7 days): 10mg TWICE daily (two 5mg tablets)
• DVT / PE Treatment (after first 7 days): 5mg TWICE daily
• DVT / PE Prevention of Recurrence (after ≥6 months treatment): 2.5mg twice daily (switch to Apigat 2.5mg)
• Post Knee Replacement Surgery: 2.5mg twice daily for 10–14 days (use Apigat 2.5mg)
• Post Hip Replacement Surgery: 2.5mg twice daily for 32–38 days (use Apigat 2.5mg)
ROUTE OF ADMINISTRATION / TIMING:
• Take doses approximately 12 hours apart at the same times each day (e.g., 8 AM and 8 PM).
• Consistent timing maintains stable plasma drug levels for optimal anticoagulant effect.
• Swallow tablets whole — do not crush, chew, split, or break them.
FOOD INTERACTIONS:
• Can be taken with or without food — no dietary restrictions required.
• Avoid excessive alcohol — increases bleeding risk.
MISSED DOSE:
• If you miss a dose, take it as soon as you remember on the same day.
• If remembered the next day, skip the missed dose and continue your regular schedule.
• Never double up on doses.
STORAGE:
• Store at room temperature below 30°C (86°F).
• Keep in original packaging, away from moisture, heat, and direct sunlight.
• Keep out of reach of children.
How it works:
• Apigat 5mg contains Apixaban, a potent oral direct Factor Xa inhibitor — one of the most clinically proven DOACs available.
MECHANISM OF ACTION:
• Blood coagulation proceeds through two converging pathways (intrinsic and extrinsic), both leading to the activation of Factor X → Factor Xa. Factor Xa catalyses the conversion of prothrombin (Factor II) to thrombin (Factor IIa), which then converts soluble fibrinogen into insoluble fibrin — the structural scaffold of a blood clot.
How Apixaban Acts:
• Apixaban works by directly, selectively, and reversibly binding to the active site of Factor Xa, blocking it from activating prothrombin. This action:
• Interrupts both the intrinsic and extrinsic coagulation pathways simultaneously
• Inhibits both free Factor Xa and Factor Xa within the prothrombinase complex
• Inhibits thrombin-induced platelet aggregation (indirectly)
• Does NOT require the cofactor antithrombin for its anticoagulant effect (unlike heparin)
KEY PHARMACOLOGICAL ADVANTAGES OVER WARFARIN:
• No routine INR/PT blood monitoring required
• Predictable, fixed twice-daily dosing
• Rapid onset (peak plasma level in 3–4 hours)
• Half-life of ~12 hours, suitable for twice-daily dosing
• No dietary vitamin K restrictions
• Fewer drug-drug interactions than warfarin
• Reversal agent available: Andexanet alfa (approved antidote for major bleeding emergencies)
Result:
• Blood flows more freely through vessels, with significantly reduced risk of dangerous clots forming in the heart, leg veins, or lungs.
Faq for medicine:
Apigat 5mg (Apixaban 5mg) is primarily used to prevent stroke and systemic embolism in adults with non-valvular atrial fibrillation. It is also used to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), supporting healthy blood flow by reducing abnormal clot formation.
2.How is Apigat 5mg different from Apigat 2.5mg in dosing?
Apigat 5mg is the standard dose used for stroke prevention in atrial fibrillation and DVT/PE treatment, while Apigat 2.5mg is typically used as a maintenance or reduced dose for patients with specific risk factors such as advanced age, low body weight, or elevated serum creatinine levels.
3.Can patients with kidney disease safely use Apigat 5mg?
Apigat 5mg requires dose adjustment in patients with moderate to severe renal impairment. Since Apixaban is partially excreted through the kidneys, impaired renal function can raise drug levels and increase bleeding risk. A physician will assess creatinine clearance before prescribing Apigat 5mg to patients with kidney disease.
4.What are the bleeding risks associated with Apigat 5mg tablets?
Apigat 5mg carries a risk of bleeding, including gastrointestinal bleeding, bruising, and in rare cases, intracranial bleeding. Patients should report unusual bleeding, prolonged cuts, or blood in urine or stool immediately. Avoid contact sports and NSAIDs while taking Apigat 5mg without physician approval.
5.Is Apigat 5mg safe for long-term use in atrial fibrillation?
Apigat 5mg is considered safe and effective for long-term use in non-valvular atrial fibrillation when prescribed and monitored by a cardiologist. Clinical studies have shown Apixaban reduces stroke risk with a lower incidence of intracranial bleeding compared to warfarin, supporting its use in ongoing AF management.
6.Does Apigat 5mg interact with common antibiotics or antifungals?
Apigat 5mg can interact with certain antibiotics and antifungals. Strong CYP3A4 inhibitors such as azole antifungals (e.g., ketoconazole) and some macrolide antibiotics can increase Apixaban blood levels, raising bleeding risk. Enzyme inducers like rifampicin can reduce efficacy. Always disclose all medications to your doctor.
Medicine interaction:
INCREASE Apixaban levels (heightened bleeding risk — AVOID or dose-reduce with caution):
• Combined P-gp + strong CYP3A4 Inhibitors: Ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin, ritonavir, lopinavir, atazanavir, indinavir
DECREASE Apixaban levels (reduced efficacy — AVOID):
• Combined P-gp + strong CYP3A4 Inducers: Rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's Wort — significantly reduce Apixaban plasma levels
INCREASE BLEEDING RISK (use only with close medical supervision):
• Other anticoagulants: Warfarin, heparin (unfractionated and LMWH), fondaparinux, other DOACs
• Antiplatelet drugs: Clopidogrel, ticagrelor, prasugrel, aspirin (especially >100mg/day)
• NSAIDs: Ibuprofen, naproxen, diclofenac — significantly raise GI and systemic bleeding risk
• SSRIs/SNRIs antidepressants: May impair platelet function and compound bleeding risk
• Thrombolytics (e.g., alteplase): Avoid concurrent use
ALCOHOL INTERACTION:
• Avoid excessive alcohol — increases bleeding risk and impairs liver metabolism.
SUPPLEMENT INTERACTIONS:
• St. John's Wort: Strictly avoid — markedly reduces Apixaban efficacy.
• High-dose omega-3/fish oil, garlic extract, ginkgo biloba, vitamin E: May potentiate antiplatelet effects.
Available Substitutes
