Brand Name US: Savaysa
Canadian Equivalent: Lixiana
“Alert: Black Box Warning
Reduced efficacy in nonvalvular atrial fibrillation patients with CrCl >95 mL/minute:
Edoxaban should not be used in patients with CrCl >95 mL/minute. In the ENGAGE AFTIMI 48 study, nonvalvular atrial fibrillation patients with CrCl >95 mL/minute had an increased rate of ischemic stroke with edoxaban 60 mg once daily compared to patients treated with warfarin. In these patients, another anticoagulant should be used.
Premature discontinuation of edoxaban increases the risk of ischemic events:
Premature discontinuation of any oral anticoagulant in the absence of adequate alternative anticoagulation increases the risk of ischemic events. If edoxaban is discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant as described in the transition guidance.
Epidural or spinal hematomas may occur in patients treated with edoxaban who are receiving neuraxial anesthesia or undergoing spinal puncture. These hematomas may result in long-term or permanent paralysis. Consider these risks when scheduling patients for spinal procedures.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Edoxaban, Savaysa/Lixiana is a selective factor Xa inhibitor, inhibits free factor Xa and prothrombinase activity and inhibits thrombin-induced platelet aggregation. Inhibition of factor Xa in the coagulation cascade reduces thrombin generation and therefore a reduction in thrombus formation and progression. The reduction in thrombin will result in indirect inhibition of platelet aggregation.
Indications For Use
Nonvalvular atrial fibrillation, venous thromboembolism (deep vein thrombosis and pulmonary embolism)
Before starting Edoxaban, Savaysa/Lixiana make sure your physician is aware of any allergies and medications you currently take. There is an increased risk of bleeding and if Edoxaban, Savaysa/Lixiana is abruptly discontinued, there is also an inherent risk of thromboembolic complications.
Oral: 60mg once daily.
Pharmacist Tips On Using
How to Take: Take with or without food. Tablets can be crushed and mixed with applesauce or 60 to 90 mL of water. For patients with a gastric tube, mix crushed tablets with 60 to 90 mL water and administer them immediately.
Hemorrhage, skin rash, vaginal bleeding, hematuria, anemia, oral hemorrhage, elevated liver enzymes, epistaxis.
Note this is not a complete list of side effects for Edoxaban, Savaysa/Lixiana only common ones.
Frequently Asked Questions
Why would my doctor give this to me if it can cause me to have a potentially fatal bleed, is it safe?
Your physician has found that given your medical conditions the reduction of risk of a major clot resulting in a heart attack or stroke far outweighs the increased risk of a bleed. Every medication does have risks however the training of your medical team has established that the benefits outweigh said risks based on their many years of experience, schooling, training, and available clinical data.