Apixaban level

Test Alias / Common Abbreviations

DOAC; Anticoagulant;

Department

Haematology

Test Purpose  

To determine apixaban levels.

Apixaban is a direct oral anticoagulant (DOAC) that inhibits factor Xa. Once bound to apixaban, factor Xa can no longer contribute to the coagulation process, thereby inducing an anticoagulant effect. Licensed indications for apixaban include the prevention of stroke and systemic embolism in non-valvular atrial fibrillation, and the treatment/prevention of pulmonary embolism/deep vein thrombosis.

Monitoring of apixaban is NOT routinely required. 

A normal PT/APTT does NOT exclude clinically significant anticoagulant effect in patients receiving DOAC.

The Apixaban Level  may be helpful to monitor anticoagulation levels in certain cohorts of patients: 
•    Trough levels are helpful to identify dose accumulation e.g. in liver and renal impairment.
•    Peak levels are helpful to confirm adequate dosing e.g. IBD, post bowel surgery. 
•    Random testing may be helpful in emergency situations e.g. prior to urgent surgery or following major bleeding.

Important Requesting Instructions

Requests must be approved by Clinical Haematology.

Urgent requests must be discussed with the laboratory.

Sample Collection Instructions

Venous whole blood is preferred. For other sample types please discuss with the laboratory.
Timing of sample: 

•    Trough levels - 12 hours post dose
•    Peak levels - 3 hours post dose

Sample Transport & Stability Information

Packaging must be compliant with Dangerous Good Safety Advisor (DGSA)   requirements click here for more information.

Samples should be delivered to the laboratory within 2 hours of venepuncture.

Sample Type, Container & Volume

2 X Citrate (Blue)

Must be filled to minimum fill line.

Turnaround Time

Urgent – 4 hours (Mon-Fri, 09:00 – 17:00)

Routine – 1 week