Apixaban Metabolism and Pharmacokinetics after Oral Administration to Humans

• Published in: Drug metabolism and disposition Vol. 37; no. 1; pp. 74 - 81
• Main Authors: Raghavan, Nirmala, Frost, Charles E., Yu, Zhigang, He, Kan, Zhang, Haiying, Humphreys, W. Griffith, Pinto, Donald, Chen, Shiangyuan, Bonacorsi, Samuel, Wong, Pancras C., Zhang, Donglu
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Elsevier Inc 01.01.2009; American Society for Pharmacology and Experimental Therapeutics
• Subjects: Administration, Oral; Adolescent; Adult; Area Under Curve; Biological and medical sciences; Chromatography, High Pressure Liquid; Humans; Magnetic Resonance Spectroscopy; Male; Mass Spectrometry; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - pharmacokinetics; Pyrazoles - administration & dosage; Pyrazoles - pharmacokinetics; Pyridones - administration & dosage; Pyridones - pharmacokinetics; Spectrophotometry, Ultraviolet; Human; Anticoagulant; Metabolism; Pharmacokinetics; Apixaban; Oral administration
• ISSN: 0090-9556; 1521-009X; 1521-009X
• DOI: 10.1124/dmd.108.023143

The metabolism and disposition of [14C]apixaban, an orally bioavailable, highly selective, and direct acting/reversible factor Xa inhibitor, was investigated in 10 healthy male subjects without (group 1, n = 6) and with bile collection (group 2, n = 4) after a single 20-mg oral dose. Urine, blood, and feces samples were collected from all subjects. Bile samples were also collected for 3 to 8 h after dosing from group 2 subjects. There were no serious adverse events or discontinuations due to adverse effects. In plasma, apixaban was the major circulating component and O-demethyl apixaban sulfate, a stable and water-soluble metabolite, was the significant metabolite. The exposure of apixaban (Cmax and area under the plasma concentration versus time curve) in subjects with bile collection was generally similar to that in subjects without bile collection. The administered dose was recovered in feces (group 1, 56.0%; group 2, 46.7%) and urine (group 1, 24.5%; group 2, 28.8%), with the parent drug representing approximately half of the recovered dose. Biliary excretion represented a minor elimination pathway (2.44% of the administered dose) from group 2 subjects within the limited collection period. Metabolic pathways identified for apixaban included O-demethylation, hydroxylation, and sulfation of hydroxylated O-demethyl apixaban. Thus, apixaban is an orally bioavailable inhibitor of factor Xa with elimination pathways that include metabolism and renal excretion.