Home Drug Guide Edoxaban

Drug Guide

Generic Name

Edoxaban

Brand Names Savaysa

Classification

Therapeutic: Anticoagulant

Pharmacological: Factor Xa Inhibitor

FDA Approved Indications

  • Prevention of stroke and systemic embolism in non-valvular atrial fibrillation
  • Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE)

Mechanism of Action

Edoxaban selectively inhibits factor Xa, which decreases thrombin generation and thrombus development.

Dosage and Administration

Adult: 60 mg once daily; dose may be adjusted based on renal function, body weight, and concomitant medications.

Pediatric: Not approved for pediatric use.

Geriatric: Efficacy and safety are similar; dose adjustment based on renal function is recommended.

Renal Impairment: Reduced doses are recommended for renal impairment (eGFR 15-50 mL/min).

Hepatic Impairment: Use is contraindicated in patients with hepatic disease expected to result in coagulopathy or increased bleeding risk.

Pharmacokinetics

Absorption: Orally absorbed with a bioavailability of approximately 62%.

Distribution: Moderate binding to plasma proteins (~55%).

Metabolism: Primarily metabolized via hydrolysis and conjugation; minor CYP3A4 involvement.

Excretion: Excreted mainly via feces (~50%) and urine (~35%).

Half Life: approximately 10-14 hours.

Contraindications

  • Active pathological bleeding
  • Known hypersensitivity to edoxaban or any component of the formulation.

Precautions

  • Bleeding risk assessment prior to therapy.
  • Use with caution in patients with renal impairment, hepatic impairment, or those at high risk of bleeding.

Adverse Reactions - Common

  • Bleeding (including hematoma, hematuria, epistaxis) (Common)
  • Anemia (Less common)

Adverse Reactions - Serious

  • Bleeding complications requiring medical intervention (Rare)
  • Spinal/epidural hematoma if used with neuraxial anesthesia (Rare)

Drug-Drug Interactions

  • Other anticoagulants, antiplatelet agents, NSAIDs, CYP3A4 or P-gp inhibitors (e.g., ketoconazole, ritonavir)

Drug-Food Interactions

  • Limit alcohol intake; no significant food interactions reported.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of bleeding, renal function, and adherence.

Diagnoses:

  • Risk for bleeding related to anticoagulant therapy.

Implementation: Administer orally once daily, assess renal function periodically, educate patient on bleeding precautions.

Evaluation: Monitor for effectiveness and adverse effects; reassess renal function and bleeding risk regularly.

Patient/Family Teaching

  • Report signs of bleeding immediately.
  • Take medication as prescribed, at the same time each day.
  • Avoid activities that increase bleeding risk.
  • Inform healthcare providers of all medications, supplements, and herbal products.

Special Considerations

Black Box Warnings:

  • Risk of spinal/epidural hematoma with neuraxial anesthesia or spinal puncture.

Genetic Factors: No specific genetic testing required.

Lab Test Interference: May prolong clotting times (e.g., PT, aPTT), but these are not reliable measures of anticoagulant effect.

Overdose Management

Signs/Symptoms: Excessive bleeding, hypotension, pallor.

Treatment: Discontinue edoxaban, provide supportive care, consider use of reversal agents like andexanet alfa if available, supportive measures like transfusions as needed.

Storage and Handling

Storage: Store at room temperature (20°C to 25°C).

Stability: Stable until expiration date on packaging.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.