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Information about Edoxaban

Edoxaban is an oral, small molecule inhibitor of factor Xa which is used as an anticoagulant to decrease the risk of venous thromboses, systemic embolization and stroke in patients with atrial fibrillation, and as treatment of deep vein thrombosis and pulmonary embolism to prevent thrombotic complications. 

Liver safety of Edoxaban

Edoxaban has been linked to a low rate of serum aminotransferase elevations during therapy, but has not been implicated in cases of clinically apparent acute liver injury.

Mechanism of action of Edoxaban

Edoxaban (e dox' a ban) is a selective inhibitor of the coagulation factor Xa, the last and rate controlling step in the generation of thrombin, the final intermediate in blood coagulation.  Inhibiting thrombin prevents the conversion of fibrinogen to fibrin and subsequent cross linking of fibrin monomers, platelet activation and amplification of coagulation activation.  Edoxaban has been shown to be as effective as warfarin in preventing stroke and systemic embolization in patients with atrial fibrillation.  Clinical trials have also shown that edoxaban can decrease the risk of complications of deep vein thrombosis and pulmonary embolism. 

FDA approval information for Edoxaban

Edoxaban was approved for use in the United States in 2015, the fourth direct factor Xa inhibitor to be approved.  Current indications are for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation and for treatment of patients with deep vein thrombosis and pulmonary embolism.  Edoxaban is available in 15, 30 and 60 mg tablets under the commercial name Savaysa.  The usual dose is 60 mg daily.  Unlike warfarin, edoxaban and the other oral direct thrombin and factor Xa inhibitors do not require monitoring of bleeding time or INR and rarely require dose adjustments. 

Side effects of Edoxaban

Side effects are not common, but can include bleeding, headache, gastrointestinal upset and rash.  Rare, but potential severe adverse reactions include major bleeding including hemorrhagic stroke.

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