Apixaban

Generic Name: apixaban (a-PIX-a-ban)
Brand Name: Eliquis

Do not stop taking apixaban without checking with your doctor. This may increase the risk of developing a blood clot, including stroke in certain patients. If you need to stop taking apixaban, follow your doctor's directions carefully.

Tell your doctor you use apixaban before you have any type of spinal or epidural procedure. Patients who have these procedures while they use apixaban are at risk of serious bleeding problems on or near the spine. This could result in long-term or permanent paralysis.

The risk is increased in patients who have a certain type of epidural catheter. It is also increased in patients with a history of traumatic or repeated epidural or spinal puncture, a deformed spine, or spinal surgery. It is also increased in patients who use medicines that may affect blood clotting, such as other anticoagulants (eg, warfarin), aspirin, platelet inhibitors (eg, clopidogrel), and nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen).

If you have a spinal or epidural procedure while you use apixaban, tell your doctor at once if you notice any symptoms of nerve problems (eg, back pain, numbness [especially in the legs and feet], tingling, muscle weakness, paralysis, loss of bowel or bladder control).

Talk with your doctor if you have recently had or will be having a spinal or epidural procedure. Some time may need to pass between the use of apixaban and your procedure. Discuss any questions or concerns with your doctor.


Apixaban is used for:

Reducing the risk of stroke and serious blood clots in certain patients with atrial fibrillation. It is also used to prevent blood clots in people who have had a hip or knee replaced. It may also be used for other conditions as determined by your doctor.

Apixaban is a direct factor Xa inhibitor. It works by blocking the formation of blood clots.

Do NOT use apixaban if:

  • you are allergic to any ingredient in apixaban
  • you have certain types of abnormal bleeding (eg, active major bleeding)
  • you have severe liver problems or an artificial heart valve
  • you are taking carbamazepine, phenytoin, rifampin, or St. John's wort

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Atrial Fibrillation - Stroke Prevention Guidelines & Treatment Options

Before using apixaban:

Some medical conditions may interact with apixaban. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of bleeding or clotting problems, high blood pressure, blood vessel problems (especially in the eyes, brain, or spinal column), anemia or other blood problems, low blood platelet levels or other platelet problems, stomach or bowel ulcers, stroke, or kidney or liver problems
  • if you have an infection of the heart
  • if you are at increased risk of bleeding
  • if you have recently had or are scheduled to have certain procedures (eg, surgery, including brain, spine, or eye surgery; dental procedures; a spinal or epidural procedure)

Some MEDICINES MAY INTERACT with apixaban. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Abciximab, alteplase, other anticoagulants (eg, enoxaparin, heparin, warfarin), aspirin, bivalirudin, dabigatran, desirudin, eptifibatide, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen, ketorolac), platelet inhibitors (eg, clopidogrel, prasugrel, ticlopidine), selective serotonin reuptake inhibitors (SSRIs) (eg, paroxetine), serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, venlafaxine), or tirofiban because the risk of bleeding may be increased
  • Azole antifungals (eg, fluconazole, itraconazole, ketoconazole, voriconazole), clarithromycin, cobicistat, erythromycin, mifepristone, nefazodone, protease inhibitors (eg, boceprevir, ritonavir), or telithromycin because they may increase the risk of apixaban's side effects, such as bleeding
  • Carbamazepine, enzalutamide, hydantoins (eg, phenytoin), phenobarbital, rifamycins (eg, rifampin ), or St. John's wort because they may decrease apixaban's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if apixaban may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use apixaban:

Use apixaban as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Apixaban comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get apixaban refilled.
  • Take apixaban by mouth with or without food.
  • Taking apixaban at the same time each day will help you remember to take it.
  • Be sure to take apixaban for the full course of treatment. If you do not, you may be at increased risk of developing blood clots. Keep taking it even if you feel well.
  • If you miss a dose of apixaban, take it as soon as possible on the same day you missed the dose then go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use apixaban.

Important safety information:

  • Do not change your dose or stop taking apixaban without checking with your doctor. Stopping apixaban may increase the risk of developing a blood clot, including stroke in certain patients. If you need to stop taking apixaban, follow your doctor's directions carefully.
  • When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not run out of apixaban.
  • Apixaban increases the risk of bleeding and can cause severe and sometimes deadly bleeding. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding; pink or brown urine; black, tarry, or bloody stools; coughing up blood; or vomit that looks like blood or coffee grounds.
  • Call your doctor right away if you fall or injure yourself, especially if you hit your head. You may need to be checked by your doctor.
  • Tell your doctor or dentist that you take apixaban before you receive any medical or dental care, emergency care, or surgery. Apixaban may need to be stopped before certain types of surgery, as directed by your doctor. If apixaban is stopped, your doctor will tell you when to start taking apixaban again after your surgery or procedure.
  • Use apixaban with caution in the ELDERLY; they may be more sensitive to its effects.
  • PREGNANCY and BREAST-FEEDING: It is not known if apixaban can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using apixaban while you are pregnant. It is not known if apixaban is found in breast milk. Do not breast-feed while taking apixaban.

Possible side effects of apixaban:

All medicines may cause side effects, but many people have no, or minor, side effects. No COMMON side effects have been reported with apixaban. Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing or swallowing; tightness or pain in the chest; swelling of the mouth, face, lips, throat, or tongue; wheezing); bloody or black, tarry stools; coughing up blood; pain, swelling, or new drainage at wound sites; pink, red, or brown urine; stiff, sore, hot, or painful joints; symptoms of anemia (eg, unusual paleness, severe or persistent headache, shortness of breath, fast heartbeat, unusual tiredness or weakness); symptoms of bleeding in the brain (eg, sudden, severe headache; one-sided weakness; vision problems; slurred speech; confusion); symptoms of low blood pressure (eg, fainting, dizziness or light-headedness); unexplained swelling; unusual or prolonged bruising or bleeding (eg, abnormal menstrual periods, frequent nosebleeds, unusual bleeding from the gums, vaginal bleeding); vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of apixaban:

Store apixaban at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep apixaban out of the reach of children and away from pets.

General information:

  • If you have any questions about apixaban, please talk with your doctor, pharmacist, or other health care provider.
  • Apixaban is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take apixaban or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about apixaban. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to apixaban. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using apixaban.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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