American Society of Hirudotherapy

Apixaban

Oral Factor Xa inhibitor — FDA approved 2012. Part of the DOAC class inspired by leech antistasin discovery.

Studied off-labelLast updated: 2026-05-26 · Reviewed by ASH Editorial Board
Molecular weight of Apixaban compared with other characterized leech-derived compoundsHementerin80 kDaHementin80 kDaHementin-Like Protein (HLP-1)80 kDaLeech Collagenase70 kDaHaemadipsa yanyuanensis Progr…70 kDaLeech Apyrase67 kDaCalin65 kDaHyaluronidase60 kDaAntithrombin III binding prot…58 kDaCollagenolytic Fibrinolysin55 kDaLeech Thrombospondin-Like Pro…50 kDaApixaban0.5 kDa
Molecular weight (kilodaltons) of Apixaban (highlighted) alongside other characterized leech salivary compounds. Smaller proteins/peptides generally diffuse and act faster.

Mechanistic Evidence Box

Studied off-label
Page type
Compound profile
Evidence type
Oral Factor Xa inhibitor — FDA approved 2012. Part of the DOAC class inspired by leech antistasin discovery.
Evidence level
FDA-cleared regulatory context
Drug vs leech
Synthetic analog
Safety domains
Bleeding

Clinical translation limit

Apixaban is a chemically synthesized small-molecule Factor Xa inhibitor; it shares only the molecular target with leech antistasin and is not structurally derived from it. Its RCT evidence base (ARISTOTLE) applies only to the drug, not to whole medicinal-leech therapy.

Molecular Profile

Category
Anticoagulant
Evidence tier
Tier A — FDA-approved derivative
Molecular weight
459.5 Da
Source species
Synthetic
Discovered
2007 · Bristol-Myers Squibb / Pfizer
PubChem CID
10182969
Derived FDA-approved drug
Eliquis (FDA approved Dec 2012)
Apixaban molecular structure

Biological Targets

  • Factor Xa

Key Citations

  1. Granger CB et al. (ARISTOTLE) (2011), N Engl J Med · PMID 21870978

Related Anticoagulant Compounds

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.