Year: 2025
Type: article
Study design: Case Report
Abstract: Objective: Therapeutic plasma exchange (TPE) may enhance the elimination of drugs from human plasma. Removal of apixaban during TPE has not been extensively described previously. Case: This is a retrospective report of a 76-year-old man admitted to the hospital on apixaban with acute worsening of respiratory and bulbar symptoms due to myasthenia gravis. On hospital day (HOD) 1, TPE was initiated for management of myasthenic crisis. Apixaban levels were obtained before and after a TPE session on HOD 3. On HOD 3, the patient’s apixaban plasma level decreased from 88 ng/mL before TPE to 81 ng/mL after. Apixaban displayed an elimination half-life of 65.5 hours with intervening TPE. Discussion/conclusions: We report no clinically significant apixaban removal in a patient undergoing TPE for myasthenic crisis. This differs from previous reports. Supplemental dosing or rescheduling of apixaban doses around TPE sessions may be unnecessary, though more data are needed.
Source: Journal of Pharmacy Technology
Authors: David Hensler, Danielle Burghardt
Institution: Michigan Medicine
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4414157791