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 |
|
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 |
---|---|---|
Oral factor Xa inhibitors for venous thromboembolism prevention in major orthopedic surgery: a review. | 2008 |
|
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 |
|
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 |
|
Oral factor Xa inhibitors for thromboprophylaxis in major orthopedic surgery: a review. | 2009 Dec |
|
New anticoagulants for atrial fibrillation. | 2009 Jul |
|
Gateways to clinical trials. | 2009 Nov |
|
Apixaban or enoxaparin for thromboprophylaxis. | 2009 Nov 19 |
|
Gateways to clinical trials. | 2009 Oct |
|
New antithrombotic drugs: potential for use in oncology. | 2009 Oct 10 |
|
[New developments in antithrombotic care]. | 2009 Sep |
|
Novel anticoagulant therapy: principle and practice. | 2010 |
|
New oral anticoagulants in development: potential for improved safety profiles. | 2010 |
|
Health trends. | 2010 Apr |
|
Potential of new anticoagulants in patients with cancer. | 2010 Apr |
|
VTE prophylaxis for the medical patient: where do we stand? - a focus on cancer patients. | 2010 Apr |
|
Antithrombotic treatment failures in antiphospholipid syndrome: the new anticoagulants? | 2010 Apr |
|
Primary prevention of venous thromboembolism in medical and surgical oncology patients. | 2010 Apr 13 |
|
Treatment of thromboembolism in cancer patients. | 2010 Aug |
|
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 |
|
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 |
|
Metabolism, pharmacokinetics and pharmacodynamics of the factor Xa inhibitor apixaban in rabbits. | 2010 Jan |
|
The new oral anticoagulants. | 2010 Jan 7 |
|
Oral factor Xa inhibitors for the prevention of stroke in atrial fibrillation. | 2010 Jul |
|
Gateways to clinical trials. | 2010 Jun |
|
Drug and dietary interactions of the new and emerging oral anticoagulants. | 2010 Jun |
|
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 |
|
[A new deal with new anticoagulants?]. | 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 |
|
Antithrombotic drugs for patients with ischaemic stroke and transient ischaemic attack to prevent recurrent major vascular events. | 2010 Mar |
|
Comparative efficacy and safety of the novel oral anticoagulants dabigatran, rivaroxaban and apixaban in preclinical and clinical development. | 2010 Mar |
|
In vitro assessment of metabolic drug-drug interaction potential of apixaban through cytochrome P450 phenotyping, inhibition, and induction studies. | 2010 Mar |
|
Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. | 2010 Mar 6 |
|
Apixaban to prevent venous thromboembolism after knee replacement. | 2010 Mar 6 |
|
Emerging anticoagulants for venous thromboembolism prevention. | 2010 May 15 |
|
Forecasting drug utilization and expenditure in a metropolitan health region. | 2010 May 17 |
|
New anticoagulants for the prevention of venous thromboembolism. | 2010 May 25 |
|
New options with dabigatran etexilate in anticoagulant therapy. | 2010 May 25 |
|
New antithrombotics for atrial fibrillation. | 2010 Oct |
|
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
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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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m1993
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Apixaban
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DB06605
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QQ-78
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Related Record | Type | Details | ||
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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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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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