Apixaban


Abbrev Code:APXBAN   
Order Code:LAB8192Order Name:Apixaban
Synonyms:Eliquis
Methodology:Chromogenic
CPT Codes: 80299 x1, 80299 x1
Turnaround Time:Testing is performed as needed; results are reported within 8 hours if received into the testing laboratory by 12 p.m. With pre-notification, STATs are done within 1 hour after receipt in the testing laboratory.
Special Instructions:See link to Specimen Collection and Processing for Coagulation Specimens.
Testing should not be performed on patients receiving the reversal agent Andexxa.  This anti-Xa assay is not suitable for measuring reversal activity of Andexxa® due to high sample dilutions, which cause dissociation of the inhibitor from Andexxa.

Peak levels are drawn 3-4 hours post dosage.
Associated Links:

Specimen Collection and Processing for Coagulation Specimens



Collection Instructions

Specimen:Blood
Optimal Volume:2.7 mL (in 3 mL tube) - filled to fill line on the tube
Minimum\Peds Volume:1.8 mL (in 2 mL tube) - filled to fill line on tube.
Container:Blue Na Citrate, 3.2% - fill to fill line on tube
Collection Instructions:Peak levels are drawn 3-4 hours post dosage.

See link to Specimen Collection and Processing for Coagulation Specimens
Causes for Rejection:Underfilled tubes, overfilled tubes, clotted specimens, not received or processed and frozen within 4 hours of collection or, specimen thawed during transit.


Processing and Shipping

Specimen Processing:
  • Process for Platelet Poor Plasma within 4 hours of collection.
  • Aliquot plasma, place clear tape around label, and freeze at -20C or on dry ice within 4 hours of collection.
  • If multiple tests are collected on 1 blue top, split each blue top into 2 aliquots. Minimum 0.5 mL per tube.
  • A maximum of 6 aliquots are needed per collection.
     
See link to Specimen Collection and Processing for Coagulation Specimens
Shipping Instructions:
  • Ensure specimen is frozen before shipping.
  • Ship on dry ice, sample must remain frozen during shipping.
     
See link to Specimen Collection and Processing for Coagulation Specimens
Stability:4 hours at room temperature
Test Performed at or Referral Lab UM Special Coag (K)  (UMMC East Bank)


Interpretive

Therapeutic Range:Therapeutic ranges have not been established for apixaban. Target "on therapy" ranges are based on levels measured in patients in clinical trials published in the literature. The on therapy range peak level measured 3-4 hours after taking the oral dose is approximately 91-321 nanogram/mL for 5 mg twice daily for stroke prevention in non-valvular atrial fibrilation and 59-302 nanogram/mL for 5 mg twice daily for venous thromboembolism treatment. [European Medcines Agency. Committee for Medicinal Products for Human Use. Assessment Report:Eliquis (apixaban) EMA/478338/2014 June 26, 2014. Accessed December 6, 2019; Byon et al. CPT Pharmacometrics Syst Pharmacol 2017, 6:340-349, Byon et al.  Clin Pharmacokinet 2019; 58:1265-1279).
Use:Apixaban (Eliquis®) assay is an anti-Xa calibrated for apixaban only.


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