Key result
Following a 300 mg Apixaban overdose, Cmax was observed at 17 hours (3654 μg/L) with a half-life of 10.8 hours, suggesting activated charcoal may be effective up to 17 hours post-ingestion.
Case Report (n=1)
A massive 300 mg apixaban overdose resulted in a delayed Tmax of 17 hours without bleeding complications, suggesting a prolonged window for activated charcoal administration.
May warrant extended monitoring after apixaban overdose; leaves open questions on optimal reversal timing.
A 67‐year‐old man was admitted to the emergency department about 5 h after deliberate self‐poisoning with 300 mg of Apixaban. The clinical examination did not show any organ dysfunctions or haemorrhagic signs, and the patient's life was not in danger. The first analysis, upon admission, showed a concentration of 2655 μg l −1 of Apixaban. The Cmax was observed 17 h after the intake (3654 μg l −1 ), about four times the classical Tmax value (median [range]: 4 h [2–4]). The Apixaban was then eliminated following a first order elimination with a calculated half‐life of 10.8 h. The anti‐Xa activity seems to be linearly related to concentration up to 4000 μg l −1 . This report suggests that the use of activated charcoal should be effective up to 17 h after a massive intake.
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Franck et al. (2018) conducted a case report in Apixaban overdose (n=1). Apixaban was evaluated on Pharmacokinetics (Cmax, Tmax, half-life). Following a 300 mg Apixaban overdose, Cmax was observed at 17 hours (3654 μg/L) with a half-life of 10.8 hours, suggesting activated charcoal may be effective up to 17 hours post-ingestion.
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