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 |
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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 n = 23 Health Status: healthy Age Group: 20-39 years Sex: M Population Size: 23 Sources: |
|
40 mg single, oral Overdose Dose: 40 mg Route: oral Route: single Dose: 40 mg Co-administed with:: digoxin(single 0.75 mg) Sources: |
unknown, 23 months n = 1 Health Status: unknown Age Group: 23 months Sex: M Population Size: 1 Sources: |
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) n = 6 Health Status: healthy Age Group: 27 years (range: 19-39 years) Sex: M Population Size: 6 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) n = 8 Health Status: healthy Age Group: 27 years (range: 20-41 years) Sex: M Population Size: 8 Sources: |
Other AEs: Haematochezia, Alanine aminotransferase increased... Other AEs: Haematochezia (1 patient) Sources: Alanine aminotransferase increased (1 patient) |
210 mg single, oral Overdose Dose: 210 mg Route: oral Route: single Dose: 210 mg Co-administed with:: levothyroxine(1.5 mg single) Sources: amitriptyline(2.5 mg, single) |
unknown, 48 years n = 1 Health Status: unknown Age Group: 48 years Sex: F Population Size: 1 Sources: |
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 Co-administed with:: apixaban(oral; 2.5 mg/12h) Sources: |
unhealthy, 85 years n = 1 Health Status: unhealthy Condition: Auricular fibrillation Age Group: 85 years Sex: F Population Size: 1 Sources: |
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 Condition: nonvalvular atrial fibrillation Sources: |
Other AEs: Thromboembolic event... Other AEs: Thromboembolic event Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Intoxication | 40 mg single, oral Overdose Dose: 40 mg Route: oral Route: single Dose: 40 mg Co-administed with:: digoxin(single 0.75 mg) Sources: |
unknown, 23 months n = 1 Health Status: unknown Age Group: 23 months Sex: M Population Size: 1 Sources: |
|
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) n = 6 Health Status: healthy Age Group: 27 years (range: 19-39 years) Sex: M Population Size: 6 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) n = 6 Health Status: healthy Age Group: 27 years (range: 19-39 years) Sex: M Population Size: 6 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) n = 8 Health Status: healthy Age Group: 27 years (range: 20-41 years) Sex: M Population Size: 8 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) n = 8 Health Status: healthy Age Group: 27 years (range: 20-41 years) Sex: M Population Size: 8 Sources: |
Poisoning | 210 mg single, oral Overdose Dose: 210 mg Route: oral Route: single Dose: 210 mg Co-administed with:: levothyroxine(1.5 mg single) Sources: amitriptyline(2.5 mg, single) |
unknown, 48 years n = 1 Health Status: unknown Age Group: 48 years Sex: F Population Size: 1 Sources: |
|
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 Co-administed with:: apixaban(oral; 2.5 mg/12h) Sources: |
unhealthy, 85 years n = 1 Health Status: unhealthy Condition: Auricular fibrillation Age Group: 85 years Sex: F Population Size: 1 Sources: |
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 Condition: nonvalvular atrial fibrillation 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 |
---|---|---|
Discovery of 1-(4-methoxyphenyl)-7-oxo-6-(4-(2-oxopiperidin-1-yl)phenyl)-4,5,6,7-tetrahydro-1H-pyrazolo[3,4-c]pyridine-3-carboxamide (apixaban, BMS-562247), a highly potent, selective, efficacious, and orally bioavailable inhibitor of blood coagulation factor Xa. | 2007 Nov 1 |
|
Emergence of new oral antithrombotics: a critical appraisal of their clinical potential. | 2008 |
|
Brave new world: the current and future use of novel anticoagulants. | 2008 |
|
The top 4 advances in antithrombotic care in the last year. | 2008 |
|
Efficacy and safety of the oral direct factor Xa inhibitor apixaban for symptomatic deep vein thrombosis. The Botticelli DVT dose-ranging study. | 2008 Aug |
|
Apixaban, an oral direct Factor Xa inhibitor: awaiting the verdict. | 2008 Dec |
|
[New anticoagulants]. | 2008 Feb |
|
Update on atrial fibrillation: part I. | 2008 Feb |
|
New oral anticoagulants in atrial fibrillation. | 2008 Jan |
|
Gateways to clinical trials. July-August 2008. | 2008 Jul-Aug |
|
New anticoagulants for treatment of venous thromboembolism. | 2008 Mar |
|
Controversies in the antiphospholipid syndrome: can we ever stop warfarin? | 2008 Nov 11 |
|
New developments in anticoagulation for atrial fibrillation. | 2008 Sep |
|
Apixaban, an oral, direct inhibitor of activated Factor Xa. | 2008 Sep |
|
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 |
|
Old and new anticoagulant agents for the prevention and treatment of patients with ischemic stroke. | 2009 |
|
Comparative pharmacodynamics and pharmacokinetics of oral direct thrombin and factor xa inhibitors in development. | 2009 |
|
Apixaban, an oral direct factor Xa inhibitor, inhibits human clot-bound factor Xa activity in vitro. | 2009 Apr |
|
Sulfation of o-demethyl apixaban: enzyme identification and species comparison. | 2009 Apr |
|
Factor Xa inhibitors--new anticoagulants for secondary haemostasis. | 2009 Aug |
|
Use of emerging oral anticoagulants in clinical practice: translating results from clinical trials to orthopedic and general surgical patient populations. | 2009 Aug |
|
Novel anticoagulants in clinical development: focus on factor Xa and direct thrombin inhibitors. | 2009 Aug |
|
Favorable therapeutic index of the direct factor Xa inhibitors, apixaban and rivaroxaban, compared with the thrombin inhibitor dabigatran in rabbits. | 2009 Aug |
|
Comparative metabolism of 14C-labeled apixaban in mice, rats, rabbits, dogs, and humans. | 2009 Aug |
|
Apixaban or enoxaparin for thromboprophylaxis after knee replacement. | 2009 Aug 6 |
|
Oral factor Xa inhibitors for thromboprophylaxis in major orthopedic surgery: a review. | 2009 Dec |
|
New anticoagulants - towards the development of an "ideal" anticoagulant. | 2009 Feb |
|
New oral anticoagulants: not quite there yet. | 2009 Jan-Feb |
|
New anticoagulants: focus on venous thromboembolism. | 2009 Jul |
|
Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. | 2009 Jun 9 |
|
[Advances in antithrombotic treatment--antithrombotics with anti-Xa effect]. | 2009 Mar |
|
Rivaroxaban -- an oral, direct Factor Xa inhibitor: lessons from a broad clinical study programme. | 2009 May |
|
Gateways to clinical trials. | 2009 Nov |
|
Gateways to clinical trials. | 2009 Oct |
|
New anticoagulants and regional anesthesia. | 2009 Oct |
|
Novel anticoagulant therapy: principle and practice. | 2010 |
|
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 Aug |
|
Phenyltriazolinones as potent factor Xa inhibitors. | 2010 Feb 15 |
|
Apixaban: an emerging oral factor Xa inhibitor. | 2010 Jan |
|
Old versus new anticoagulants: focus on pharmacology. | 2010 Jun |
|
Effect of the direct factor Xa inhibitor apixaban in rat models of thrombosis and hemostasis. | 2010 Jun |
|
[Pulmonary circulation: contributions of the year 2009]. | 2010 Mar |
|
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 Mar |
|
Apixaban for reduction in stroke and other ThromboemboLic events in atrial fibrillation (ARISTOTLE) trial: design and rationale. | 2010 Mar |
|
Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development. | 2010 Mar |
|
New anticoagulants for the prevention of venous thromboembolism. | 2010 May 25 |
|
New antithrombotics for atrial fibrillation. | 2010 Oct |
|
Novel oral anticoagulants: implications in the perioperative setting. | 2010 Sep |
|
Role of orally available antagonists of factor Xa in the treatment and prevention of thromboembolic disease: focus on rivaroxaban. | 2010 Sep |
Substance Class |
Chemical
Created
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admin
on
Edited
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on
Fri Dec 15 15:59:33 GMT 2023
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Record UNII |
3Z9Y7UWC1J
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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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ELIQUIS
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PRIMARY | APPROVED DECEMBER 2012 | ||
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EXCRETED UNCHANGED |
URINE
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METABOLIC ENZYME -> SUBSTRATE | |||
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TARGET -> INHIBITOR |
Ki
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BINDER->LIGAND |
BINDING
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TARGET -> INHIBITOR |
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EXCRETED UNCHANGED |
FECAL
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METABOLITE -> PARENT |
MINOR
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METABOLITE -> PARENT |
MAJOR
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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 |
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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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