Details
| Stereochemistry | ACHIRAL |
| Molecular Formula | C25H25N5O4 |
| Molecular Weight | 459.4971 |
| Optical Activity | NONE |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
COC1=CC=C(C=C1)N2N=C(C(N)=O)C3=C2C(=O)N(CC3)C4=CC=C(C=C4)N5CCCCC5=O
InChI
InChIKey=QNZCBYKSOIHPEH-UHFFFAOYSA-N
InChI=1S/C25H25N5O4/c1-34-19-11-9-18(10-12-19)30-23-20(22(27-30)24(26)32)13-15-29(25(23)33)17-7-5-16(6-8-17)28-14-3-2-4-21(28)31/h5-12H,2-4,13-15H2,1H3,(H2,26,32)
| Molecular Formula | C25H25N5O4 |
| Molecular Weight | 459.4971 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 0 |
| Optical Activity | NONE |
Apixaban is an orally active inhibitor of coagulation factor Xa with anticoagulant activity. Apixaban directly inhibits factor Xa, thereby interfering with the conversion of prothrombin to thrombin and preventing formation of cross-linked fibrin clots. Apixaban has been available in Europe since May 2012. An FDA decision on apixaban which was expected on June 28, 2012 was initially delayed before final approval on December 28, 2012. On August 21, 2014, Pfizer announced that apixaban was now FDA approved for treatment and secondary prophylaxis of deep vein thrombosis (DVT) and pulmonary embolism (PE). It is being developed in a joint venture by Pfizer and Bristol-Myers Squibb. It has also been used to lower the risk of developing venous thrombosis post-orthopedic surgical procedures.
CNS Activity
Sources: http://www.ncbi.nlm.nih.gov/pubmed/?term=22997573
Curator's Comment: Apixaban is substrate of p-glycoprotein (p-gp), a ubiquitous transmembrane receptor found in the intestinal wall, as well as various other locations in the body, including the blood-brain barrier. P-gp actively transports molecules with diverse conformations, including drugs, across tissue monolayers.
Originator
Curator's Comment: In 2007, Pfizer and Bristol-Myers Squibb entered into a worldwide collaboration to develop and commercialize apixaban, an oral anticoagulant discovered by Bristol-Myers Squibb. This global alliance combines Bristol-Myers Squibb's long-standing strengths in cardiovascular drug development and commercialization with Pfizer’s global scale and expertise in this field. # Bristol-Myers Squibb
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: P00742 Gene ID: 2159.0 Gene Symbol: F10 Target Organism: Homo sapiens (Human) |
0.22 µM [IC50] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Secondary | ELIQUIS Approved UseIndicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation; for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery; for the treatment of DVT and PE, and for the reduction in the risk of recurrent DVT and PE following initial therapy. Launch Date2012 |
|||
| Secondary | ELIQUIS Approved UseIndicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation; for the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery; for the treatment of DVT and PE, and for the reduction in the risk of recurrent DVT and PE following initial therapy. Launch Date2012 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
207 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23488672/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
APIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
2024 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23488672/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
APIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
12 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/23488672/ |
10 mg single, oral dose: 10 mg route of administration: Oral experiment type: SINGLE co-administered: |
APIXABAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
Doses
| Dose | Population | Adverse events |
|---|---|---|
50 mg single, oral Highest studied dose |
healthy, 20-39 years |
|
40 mg single, oral Overdose |
unknown, 23 months |
Other AEs: Intoxication... |
2.5 mg 2 times / day steady, oral Dose: 2.5 mg, 2 times / day Route: oral Route: steady Dose: 2.5 mg, 2 times / day Sources: |
healthy, 27 years (range: 19-39 years) Health Status: healthy Age Group: 27 years (range: 19-39 years) Sex: M Sources: |
Disc. AE: Headache, Nausea... AEs leading to discontinuation/dose reduction: Headache (1 patient) Sources: Nausea (1 patient) |
25 mg 2 times / day steady, oral Highest studied dose Dose: 25 mg, 2 times / day Route: oral Route: steady Dose: 25 mg, 2 times / day Sources: |
healthy, 27 years (range: 20-41 years) Health Status: healthy Age Group: 27 years (range: 20-41 years) Sex: M Sources: |
Other AEs: Haematochezia, Alanine aminotransferase increased... Other AEs: Haematochezia (1 patient) Sources: Alanine aminotransferase increased (1 patient) |
210 mg single, oral Overdose |
unknown, 48 years |
Other AEs: Poisoning... |
2.5 mg 1 times / day steady, oral Dose: 2.5 mg, 1 times / day Route: oral Route: steady Dose: 2.5 mg, 1 times / day Sources: |
unhealthy, 85 years |
Disc. AE: Hepatotoxicity... AEs leading to discontinuation/dose reduction: Hepatotoxicity (1 patient) Sources: |
25 mg 2 times / day steady, oral Overdose Dose: 25 mg, 2 times / day Route: oral Route: steady Dose: 25 mg, 2 times / day Sources: |
healthy Health Status: healthy Sources: |
|
5 mg 2 times / day steady, oral Recommended Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Other AEs: Thromboembolic event... Other AEs: Thromboembolic event Sources: |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Intoxication | 40 mg single, oral Overdose |
unknown, 23 months |
|
| Headache | 1 patient Disc. AE |
2.5 mg 2 times / day steady, oral Dose: 2.5 mg, 2 times / day Route: oral Route: steady Dose: 2.5 mg, 2 times / day Sources: |
healthy, 27 years (range: 19-39 years) Health Status: healthy Age Group: 27 years (range: 19-39 years) Sex: M Sources: |
| Nausea | 1 patient Disc. AE |
2.5 mg 2 times / day steady, oral Dose: 2.5 mg, 2 times / day Route: oral Route: steady Dose: 2.5 mg, 2 times / day Sources: |
healthy, 27 years (range: 19-39 years) Health Status: healthy Age Group: 27 years (range: 19-39 years) Sex: M Sources: |
| Alanine aminotransferase increased | 1 patient | 25 mg 2 times / day steady, oral Highest studied dose Dose: 25 mg, 2 times / day Route: oral Route: steady Dose: 25 mg, 2 times / day Sources: |
healthy, 27 years (range: 20-41 years) Health Status: healthy Age Group: 27 years (range: 20-41 years) Sex: M Sources: |
| Haematochezia | 1 patient | 25 mg 2 times / day steady, oral Highest studied dose Dose: 25 mg, 2 times / day Route: oral Route: steady Dose: 25 mg, 2 times / day Sources: |
healthy, 27 years (range: 20-41 years) Health Status: healthy Age Group: 27 years (range: 20-41 years) Sex: M Sources: |
| Poisoning | 210 mg single, oral Overdose |
unknown, 48 years |
|
| Hepatotoxicity | 1 patient Disc. AE |
2.5 mg 1 times / day steady, oral Dose: 2.5 mg, 1 times / day Route: oral Route: steady Dose: 2.5 mg, 1 times / day Sources: |
unhealthy, 85 years |
| Thromboembolic event | 5 mg 2 times / day steady, oral Recommended Dose: 5 mg, 2 times / day Route: oral Route: steady Dose: 5 mg, 2 times / day Sources: |
unhealthy Health Status: unhealthy Sources: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 56.0 |
minor [IC50 20 uM] | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no | |||
Page: 15.0 |
no |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 15.0 |
minor | |||
Page: 15.0 |
minor | |||
Page: 15.0 |
minor | |||
Page: 15.0 |
minor | |||
Page: 15.0 |
minor | |||
Page: 55.0 |
no | |||
Page: 55.0 |
no | |||
Page: 55.0 |
no | |||
Page: 55.0 |
no | |||
Page: 55.0 |
no | |||
Page: 55.0 |
no | |||
Page: 55.0 |
yes | |||
Page: 9.0 |
yes | yes (co-administration study) Comment: ketoconazole increased cmax of apixaban 1.5x, auc 2x Page: 9.0 |
||
Page: 9.0 |
yes | yes (co-administration study) Comment: ketoconazole increased cmax of apixaban 1.5x, auc 2x Page: 9.0 |
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 37.0 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| New antithrombotics for atrial fibrillation. | 2010-10 |
|
| Novel oral anticoagulants: implications in the perioperative setting. | 2010-09 |
|
| Quantification of apixaban's therapeutic utility in prevention of venous thromboembolism: selection of phase III trial dose. | 2010-09 |
|
| New antithrombotic agents--insights from clinical trials. | 2010-09 |
|
| Role of orally available antagonists of factor Xa in the treatment and prevention of thromboembolic disease: focus on rivaroxaban. | 2010-09 |
|
| Treatment of thromboembolism in cancer patients. | 2010-08 |
|
| Apixaban, a direct factor Xa inhibitor, inhibits tissue-factor induced human platelet aggregation in vitro: comparison with direct inhibitors of factor VIIa, XIa and thrombin. | 2010-08 |
|
| Antithrombotic and anticoagulant profiles of TAK-442, a novel factor Xa inhibitor, in a rabbit model of venous thrombosis. | 2010-08 |
|
| Oral factor Xa inhibitors for the prevention of stroke in atrial fibrillation. | 2010-07 |
|
| Gateways to clinical trials. | 2010-06 |
|
| Drug and dietary interactions of the new and emerging oral anticoagulants. | 2010-06 |
|
| Old versus new anticoagulants: focus on pharmacology. | 2010-06 |
|
| Effect of the direct factor Xa inhibitor apixaban in rat models of thrombosis and hemostasis. | 2010-06 |
|
| [A new deal with new anticoagulants?]. | 2010-06 |
|
| New anticoagulants for the prevention of venous thromboembolism. | 2010-05-25 |
|
| New options with dabigatran etexilate in anticoagulant therapy. | 2010-05-25 |
|
| Forecasting drug utilization and expenditure in a metropolitan health region. | 2010-05-17 |
|
| Emerging anticoagulants for venous thromboembolism prevention. | 2010-05-15 |
|
| Primary prevention of venous thromboembolism in medical and surgical oncology patients. | 2010-04-13 |
|
| Health trends. | 2010-04 |
|
| Potential of new anticoagulants in patients with cancer. | 2010-04 |
|
| VTE prophylaxis for the medical patient: where do we stand? - a focus on cancer patients. | 2010-04 |
|
| Antithrombotic treatment failures in antiphospholipid syndrome: the new anticoagulants? | 2010-04 |
|
| Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. | 2010-03-06 |
|
| Apixaban to prevent venous thromboembolism after knee replacement. | 2010-03-06 |
|
| [Pulmonary circulation: contributions of the year 2009]. | 2010-03 |
|
| Rationale and design of AVERROES: apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment. | 2010-03 |
|
| Apixaban for reduction in stroke and other ThromboemboLic events in atrial fibrillation (ARISTOTLE) trial: design and rationale. | 2010-03 |
|
| Antithrombotic drugs for patients with ischaemic stroke and transient ischaemic attack to prevent recurrent major vascular events. | 2010-03 |
|
| Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development. | 2010-03 |
|
| In vitro assessment of metabolic drug-drug interaction potential of apixaban through cytochrome P450 phenotyping, inhibition, and induction studies. | 2010-03 |
|
| Phenyltriazolinones as potent factor Xa inhibitors. | 2010-02-15 |
|
| New oral anticoagulants: a practical guide for clinicians. | 2010-02 |
|
| The new oral anticoagulants. | 2010-01-07 |
|
| Apixaban: an emerging oral factor Xa inhibitor. | 2010-01 |
|
| Metabolism, pharmacokinetics and pharmacodynamics of the factor Xa inhibitor apixaban in rabbits. | 2010-01 |
|
| Novel anticoagulant therapy: principle and practice. | 2010 |
|
| New oral anticoagulants in development: potential for improved safety profiles. | 2010 |
|
| Oral anticoagulation with Factor Xa and thrombin inhibitors: Is there an alternative to warfarin? | 2009-12 |
|
| Oral factor Xa inhibitors for thromboprophylaxis in major orthopedic surgery: a review. | 2009-12 |
|
| Apixaban or enoxaparin for thromboprophylaxis. | 2009-11-19 |
|
| Gateways to clinical trials. | 2009-11 |
|
| New antithrombotic drugs: potential for use in oncology. | 2009-10-10 |
|
| Gateways to clinical trials. | 2009-10 |
|
| [New developments in antithrombotic care]. | 2009-09 |
|
| Apixaban or enoxaparin for thromboprophylaxis after knee replacement. | 2009-08-06 |
|
| New anticoagulants for atrial fibrillation. | 2009-07 |
|
| The prevention and treatment of venous thromboembolism with LMWHs and new anticoagulants. | 2009 |
|
| Selecting the optimal antithrombotic regimen for patients with acute coronary syndromes undergoing percutaneous coronary intervention. | 2009 |
|
| Oral factor Xa inhibitors for venous thromboembolism prevention in major orthopedic surgery: a review. | 2008 |
| Substance Class |
Chemical
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Validated (UNII)
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LIVERTOX |
NBK548281
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WHO-ATC |
B01AF02
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NCI_THESAURUS |
C263
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EMA ASSESSMENT REPORTS |
ELIQUIS (AUTHORIZED: ARTHROPLASTY)
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LOINC |
74214-8
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WHO-VATC |
QB01AF02
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EMA ASSESSMENT REPORTS |
ELIQUIS (AUTHORIZED: VENOUS THROMBOEMBOLISM)
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NDF-RT |
N0000175637
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100000091294
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6390
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SUB25425
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ELIQUIS
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PRIMARY | APPROVED DECEMBER 2012 | ||
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C522181
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CHEMBL231779
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m1993
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503612-47-3
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Apixaban
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APIXABAN
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DB06605
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QQ-78
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C61308
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METABOLIC ENZYME -> NON-INDUCER |
In human hepatocytes.
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EXCRETED UNCHANGED |
URINE
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METABOLIC ENZYME -> NON-INDUCER |
In human hepatocytes.
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METABOLIC ENZYME -> SUBSTRATE |
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METABOLIC ENZYME -> NON-INHIBITOR |
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TARGET -> INHIBITOR |
Ki
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METABOLIC ENZYME -> NON-INHIBITOR |
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METABOLIC ENZYME -> NON-INHIBITOR |
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BINDER->LIGAND |
BINDING
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TARGET -> INHIBITOR |
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METABOLIC ENZYME -> NON-INHIBITOR |
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METABOLIC ENZYME -> NON-INHIBITOR |
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EXCRETED UNCHANGED |
FECAL
|
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METABOLIC ENZYME -> NON-INDUCER |
In human hepatocytes.
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METABOLIC ENZYME -> NON-INHIBITOR |
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| Related Record | Type | Details | ||
|---|---|---|---|---|
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METABOLITE -> PARENT |
MINOR
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METABOLITE -> PARENT |
MAJOR
PLASMA
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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IMPURITY -> PARENT |
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ACTIVE MOIETY |
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| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
|---|---|---|---|---|---|---|
| Biological Half-life | PHARMACOKINETIC |
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| Tmax | PHARMACOKINETIC |
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ORAL ADMINISTRATION |
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| Volume of Distribution | PHARMACOKINETIC |
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