Lixiana

Lixiana is the brand name used for the anticoagulant edoxaban in the European Union, Japan, and several other markets. In the United States the same drug is marketed as Savaysa. Edoxaban is an oral direct anticoagulant that inhibits factor Xa, reducing thrombin generation and limiting clot formation.

Indications vary by region but commonly include prevention of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, and treatment of deep vein thrombosis and pulmonary embolism. Some labeling also covers venous thromboembolism prophylaxis after certain orthopedic surgeries; regional approvals differ.

Mechanism: edoxaban is a selective direct inhibitor of factor Xa, leading to decreased generation of thrombin and reduced clot formation.

Dosing: the standard dose is 60 mg once daily. A reduced dose of 30 mg once daily is used for patients with creatinine clearance (CrCl) 15–50 mL/min, body weight 60 kg or less, or concomitant use of certain drug interactions (notably P-glycoprotein inhibitors). Exposure and efficacy can be reduced in patients with very high CrCl (around 95 mL/min or more), and some indications may exclude use in those patients.

Administration and safety: tablets are taken once daily with or without meals. Edoxaban carries a risk of major bleeding and is contraindicated in active major bleeding, significant hepatic impairment, pregnancy, lactation, and certain hypersensitivity scenarios. Drug interactions with P-glycoprotein and other enzyme inhibitors or inducers may require dose adjustments and caution.

Regulatory status: Lixiana has approvals in multiple regions and is marketed by Daiichi Sankyo. It is part of the direct oral anticoagulant class, which also includes rivaroxaban, apixaban, and dabigatran and generally does not require routine coagulation monitoring.