Skip to content
The Policy VaultThe Policy Vault

Eliquis tablets for oral suspensionMedica

Treatment or prevention of other thromboembolic-related conditions (e.g., superficial vein thrombosis, splanchnic vein thrombosis, hepatic vein thrombosis, or prophylaxis of venous thromboembolism in a high-risk patient)

Initial criteria

  • Patient weighs < 35 kg
  • AND Patient has tried warfarin, fondaparinux, or a low molecular weight heparin product (e.g., enoxaparin, dalteparin)
  • OR Patient has been started on Eliquis tablets for oral suspension or Eliquis capsules for oral suspension for treatment of an acute thromboembolic condition

Approval duration

6 months