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Category Haematology >> Specialised Coagulation Services
Test background

Apixaban is a direct oral anticoagulant (DOAC) which exerts its anticoagulant effect through its ability to directly inhibit Coagulation Factor X. Plasma Apixaban levels are measured in mass concentration by chromogenic anti-Xa assay using drug-specific calibrators.

Clinical Indications

Recommended as an option for (NICE Guidelines 2016 – KTT16)

• Prevention of VTE after elective hip or knee replacement
• Treatment and secondary prevention of DVT and/or PE
• Prevention of stroke and systemic embolism in people with non-valvular AF

DOAC monitoring is not generally required; however measurement may be useful where clearance is compromised or where patients are actively bleeding.

Reference range

BCSH Guidelines (2014) Measurement of non-coumarin anticoagulants and their effects on tests of Haemostasis:

Dose Peak
(mean and range)
(mean and range)
Apixaban 2.5 mg bd 62 ng/mL (CV 37%) 21 ng/mL (CV 17%)
Apixaban 5 mg bd 128 ng/mL (CV 10%) 50 ng/mL (CV 20%)
Sample & container required 4.5 mL sodium citrate (pale blue top) adults 1.8 mL sodium citrate (pale blue top) paediatrics
Turnaround time <24 hours (core hours)

Please Note: Samples will be rejected if under/over-filled, clotted or haemolysed