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Updated: Jan 18, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Effect of Therapeutic Plasma Exchange on Apixaban Plasma Levels
David Hensler1, Danielle Burghardt1
1Department of Pharmacy Services, Michigan Medicine, Ann Arbor, MI, USA.
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.
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