ASH Clinical News FINAL_ACN_3.14_FULL_ISSUE_DIGITAL | Page 97

ELIQUIS for initial DVT/PE treatment*— And for appropriate patients, continue on a low dose † to reduce the risk of recurrent DVT/PE following initial therapy 1 To learn more about ELIQUIS, visit hcp.eliquis.com *Initial therapy: 10 mg, orally twice daily for the fi rst 7 days. After 7 days, 5 mg orally twice daily. † Extended therapy: 2.5 mg, orally twice daily. Please see full dosing information in the Prescribing Information. IMPORTANT SAFETY INFORMATION WARNINGS AND PRECAUTIONS (cont’d) The next dose of ELIQUIS should not be administered earlier than 5 hours after the removal of the catheter. The risk may also be increased by traumatic or repeated epidural or spinal puncture. If traumatic puncture occurs, delay the administration of ELIQUIS for 48 hours. Monitor patients frequently and if neurological compromise is noted, urgent diagnosis and treatment is necessary. Physicians should consider the potential benefi t versus the risk of neuraxial intervention in ELIQUIS patients. • Prosthetic Heart Valves: The safety and effi cacy of ELIQUIS have not been studied in patients with prosthetic heart valves and is not recommended in these patients. • Acute PE in Hemodynamically Unstable Patients or Patients who Require Thrombolysis or Pulmonary Embolectomy: Initiation of ELIQUIS is not recommended as an alternative to unfractionated heparin for the initial treatment of patients with PE who present with hemodynamic instability or who may receive thrombolysis or pulmonary embolectomy. ADVERSE REACTIONS • The most common and most serious adverse reactions reported with ELIQUIS were related to bleeding. TEMPORARY INTERRUPTION FOR SURGERY AND OTHER INTERVENTIONS • ELIQUIS should be discontinued at least 48 hours prior to elective surgery or invasive procedures with a moderate or high risk of unacceptable or clinically signifi cant bleeding. ELIQUIS should be discontinued at least 24 hours prior to elective surgery or invasive procedures with a low risk of bleeding or where the bleeding would be noncritical in location and easily controlled. Bridging anticoagulation during the 24 to 48 hours after stopping ELIQUIS and prior to the intervention is not generally required. ELIQUIS should be restarted after the surgical or other procedures as soon as adequate hemostasis has been established. DRUG INTERACTIONS • Strong Dual Inhibitors of CYP3A4 and P-gp: Inhib