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 Date1.35665274E12 |
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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 Date1.35665274E12 |
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 |
---|---|---|
Oral anticoagulants in development: focus on thromboprophylaxis in patients undergoing orthopaedic surgery. | 2006 |
|
Oral, direct factor Xa inhibitors in development for the prevention and treatment of thromboembolic diseases. | 2007 Jun |
|
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 |
|
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 |
|
Gateways to clinical trials. July-August 2008. | 2008 Jul-Aug |
|
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 |
|
Use of anticoagulants in elderly patients: practical recommendations. | 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 |
|
Recent developments in the use of oral anticoagulants. | 2009 Aug |
|
Apixaban or enoxaparin for thromboprophylaxis after knee replacement. | 2009 Aug 6 |
|
Oral anticoagulation with Factor Xa and thrombin inhibitors: Is there an alternative to warfarin? | 2009 Dec |
|
New anticoagulants - towards the development of an "ideal" anticoagulant. | 2009 Feb |
|
Apixaban metabolism and pharmacokinetics after oral administration to humans. | 2009 Jan |
|
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 |
|
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 antithrombotic drugs: potential for use in oncology. | 2009 Oct 10 |
|
Novel anticoagulant therapy: principle and practice. | 2010 |
|
New oral anticoagulants in development: potential for improved safety profiles. | 2010 |
|
VTE prophylaxis for the medical patient: where do we stand? - a focus on cancer patients. | 2010 Apr |
|
Antithrombotic and anticoagulant profiles of TAK-442, a novel factor Xa inhibitor, in a rabbit model of venous thrombosis. | 2010 Aug |
|
New oral anticoagulants: a practical guide for clinicians. | 2010 Feb |
|
Phenyltriazolinones as potent factor Xa inhibitors. | 2010 Feb 15 |
|
Apixaban: an emerging oral factor Xa inhibitor. | 2010 Jan |
|
Drug and dietary interactions of the new and emerging oral anticoagulants. | 2010 Jun |
|
Old versus new anticoagulants: focus on pharmacology. | 2010 Jun |
|
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 |
|
In vitro assessment of metabolic drug-drug interaction potential of apixaban through cytochrome P450 phenotyping, inhibition, and induction studies. | 2010 Mar |
|
Forecasting drug utilization and expenditure in a metropolitan health region. | 2010 May 17 |
|
Novel oral anticoagulants: implications in the perioperative setting. | 2010 Sep |
|
Quantification of apixaban's therapeutic utility in prevention of venous thromboembolism: selection of phase III trial dose. | 2010 Sep |
|
New antithrombotic agents--insights from clinical trials. | 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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on
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Fri Dec 15 15:59:33 UTC 2023
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Fri Dec 15 15:59:33 UTC 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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100000091294
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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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3Z9Y7UWC1J
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Apixaban
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APIXABAN
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1364430
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DB06605
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QQ-78
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C61308
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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 |
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FECAL
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METABOLITE -> PARENT |
MINOR
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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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Volume of Distribution | PHARMACOKINETIC |
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