Apixaban (Eliquis®)

SELF ADMINISTRATION: ORAL

Indications for Prior Authorization:

  • Approvable to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation

Patients must meet the following criteria for the indication(s) above:

  • Diagnosis of nonvalvular atrial fibrillation

The Following Conditions Do Not Meet the Criteria for Use as Established by the WHA P & T Committee:

  • All non-FDA approved uses not listed in the approved indications

Recommended Dosing:

  • 5mg twice a day
  • Age > 80 years, or body weight <60 kg, or serum creatinine > 1.5 mg/dL: 2.5 mg twice a day

Approval:

One year


 

Last review date: December 2, 2013

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