Cardiovascular diseases are still the most important cause of morbidity and 
mortality worldwide and anti-thrombotic treatment is widely used as a result. 
The currently used drugs include heparin and its derivatives, vitamin K 
antagonists, though efficacious, have their own set of limitations like 
unpredictable pharmacokinetic profile, parenteral route (with heparin and its 
derivatives only), narrow therapeutic window, and constant laboratory monitoring 
for their efficacy and safety. This lead to the development of novel factor Xa 
inhibitors which could be given orally, have predictable dose response 
relationship and are associated with lesser hemorrhagic complications. They 
include rivaroxaban, apixaban, and edoxaban among others. Apixaban has currently 
been approved for use in patients undergoing total knee or hip replacement 
surgery and to prevent stroke in patients with atrial fibrillation. Many trials 
are ongoing for apixaban to firmly establish its place in future, among the 
anti-thrombotic drugs.