Conditions w/ increased risk of haemorrhage. Discontinue if severe haemorrhage occurs. Concomitant use w/ antiplatelet agents; SSRIs, SNRIs, NSAIDs including ASA. Acute ischemic stroke. Not recommended in patients w/ prosthetic heart valves, w/ or w/o atrial fibrillation; history of thrombosis w/ diagnosed antiphospholipid syndrome. Discontinue at least 48 hr prior to elective surgery or invasive procedures w/ a moderate or high risk of bleeding; at least 24 hr prior to elective surgery or invasive procedures w/ a low risk of bleeding. Temporarily discontinue for active bleeding, elective surgery, or invasive procedures; avoid lapses in therapy & restart as soon as possible. Not recommended as alternative to unfractionated heparin in patients w/ pulmonary embolism who are haemodynamically unstable or may receive thrombolysis or pulmonary embolectomy. Frequently monitor for signs & symptoms of neurological impairment (eg, numbness or weakness of the legs, bowel or bladder dysfunction). Active cancer. Increased haemorrhagic risk in low body wt (<60 kg). Concomitant use w/ CYP3A4, P-gp inducers or HIV PI inhibitors is not recommended; CYP3A4 & P-gp inducers. Patients w/ rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicinal product. Not recommended in patients w/ renal impairment (CrCl <15 mL/min) & those undergoing dialysis. Mild to severe (not recommended) hepatic impairment. Concomitant use w/ strong CYP3A4 & P-gp inhibitors [eg, azole-antimycotics (ketoconazole, itraconazole, voriconazole & posaconazole), HIV PIs (ritonavir)] or inducers (eg, rifampin, phenytoin, carbamazepine, phenobarb or St. John's wort), antiplatelet agents, NSAIDs. Not recommended during pregnancy. Lactation. Elderly. Childn & adolescent <18 yr.
Xagulant 2.5 Risk of developing spinal or epidural hematoma during spinal/epidural anesth or puncture which can result in long-term or permanent paralysis. Remove at least 5 hr prior to the 1st dose of apixaban indwelling epidural or intrathecal catheters. Not recommended in patients undergoing hip fracture surgery.