Edoxaban
A once-daily oral factor Xa inhibitor for stroke prevention in atrial fibrillation and for DVT and PE after initial injected anticoagulation.
Drug card
- How it works
- Binding factor Xa directly, so less thrombin is made
- Used for
- Preventing stroke in nonvalvular atrial fibrillation
- Treating deep vein thrombosis
- Treating pulmonary embolism
- Known for
- Bleeding
- Its name
- -xaban means a direct factor Xa inhibitor
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does edoxaban work?
A selective factor Xa inhibitor that needs no antithrombin; it blocks free factor Xa and prothrombinase and lessens thrombin-induced platelet aggregation. Little of it is metabolized: about half of its clearance is by the kidneys as unchanged drug, and its half-life is 10 to 14 hours.
Like other direct factor Xa inhibitors: They bind factor Xa themselves, with no need for antithrombin, and block it both free in the blood and inside the prothrombinase complex. Less prothrombin is converted to thrombin, so less fibrin is laid down and clots grow less. They have no direct effect on platelets, but they reduce the platelet aggregation that thrombin would trigger.
Uses
What is edoxaban used for?
- Preventing stroke in nonvalvular atrial fibrillation
- Treating deep vein thrombosis
- Treating pulmonary embolism
Side effects
Side effects of edoxaban
- BleedingKnown forSerious
- Anemia
- Rash and hives
- Abnormal liver function tests
- Spinal or epidural hematoma after spinal proceduresSerious
- Ischemic events if stopped earlySerious
- Low platelet count
- Angioedema and other allergic reactionsSerious
- Kidney injury (anticoagulant-related nephropathy)Serious
- Abdominal pain
- Dizziness
- Headache
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Atrial fibrillation with creatinine clearance above 95 mL/min (boxed warning): more ischemic strokes than with warfarin, so another drug is used.
- For DVT and PE it is started only after 5 to 10 days of an injected anticoagulant.
- Not recommended with mechanical heart valves, moderate to severe mitral stenosis, or triple-positive antiphospholipid syndrome.
- Avoid with rifampin, which lowers its levels, and with long-term use of other anticoagulants.
Good to know: Its boxed warning is unusual: in atrial fibrillation, very good kidney function (CrCl above 95 mL/min) lowers its blood levels and its benefit.
Remember it
A way to remember it
Xa marks the spot: these drugs go straight for factor Xa, with no antithrombin needed.
Heparins reach factor Xa only through antithrombin. These drugs bind factor Xa themselves, both free and inside the prothrombinase complex, so less thrombin is made.
Written for biofideX
Its name
-xaban means direct factor Xa inhibitor
Rivaroxaban, apixaban and edoxaban are taken by mouth and block factor Xa directly. Fondaparinux (-parinux) also targets factor Xa, but indirectly.
- Every drug name stem
Its class
Direct factor Xa inhibitors
Other direct factor Xa inhibitors with a card:
Easily mixed up with heparins, direct thrombin inhibitors and vitamin K antagonists.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Blood clots and cholesterol
Edoxaban is one of 19 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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