What is the mechanism of action of the anticoagulant apixaban?

Apixaban works as a direct factor Xa inhibitor, which means it specifically targets and inhibits the activity of factor Xa, an essential component in the coagulation cascade responsible for converting prothrombin to thrombin. By inhibiting factor Xa, apixaban effectively reduces thrombin generation, leading to decreased fibrin formation and ultimately preventing the development of blood clots. This mechanism allows apixaban to act as an effective anticoagulant, particularly useful in conditions like atrial fibrillation and venous thromboembolism.

This targeted action provides a therapeutic advantage since it directly interferes with the coagulation process without the need for antithrombin, distinguishing it from other types of anticoagulants, such as those that act on vitamin K or indirectly influence thrombin.