Generic Name: apixaban (a PIX a ban)
Brand Name: Eliquis
What is apixaban?
Apixaban keeps the platelets in your blood from coagulating (clotting).
Apixaban is used in people with atrial fibrillation (a heart rhythm disorder) to lower the risk of stroke caused by a blood clot.
Apixaban is also used after hip or knee replacement surgery to prevent a type of blood clot called deep vein thrombosis (DVT), which can lead to blood clots in the lungs (pulmonary embolism).
Apixaban may also be used for purposes not listed in this medication guide.
What is the most important information I should know about apixaban?
You should not take apixaban if you have an artificial heart valve, or if you have any active bleeding from a surgery, injury, or other cause.
Apixaban can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot can lead to long-term or permanent paralysis.
Get emergency medical help if you have symptoms of a spinal cord blood clot such as back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.
Do not stop taking apixaban unless your doctor tells you to. Stopping suddenly can increase your risk of blood clot or stroke. Your doctor may prescribe another medicine to prevent blood clots.
What should I discuss with my healthcare provider before taking apixaban?
You should not take apixaban if you are allergic to it, if you have an artificial heart valve, or if you have any active bleeding from a surgery, injury, or other cause.
Apixaban may cause you to bleed more easily, especially if you have a bleeding disorder that is inherited or caused by disease.
To make sure apixaban is safe for you, tell your doctor if you have:
if you are older than 80; or
if you weigh less than 132 pounds.
Apixaban can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term paralysis, and may be more likely to occur if:
you have a spinal catheter in place or if a catheter has been recently removed;
you have a history of spinal surgery or repeated spinal taps;
you have recently had a spinal tap or epidural anesthesia;
you are taking an NSAID (nonsteroidal anti-inflammatory drug)--ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or
you are using other medicines to treat or prevent blood clots.
FDA pregnancy category B. Apixaban is not expected to cause birth defects. However, taking this medicine during pregnancy may increase the risk of bleeding while you are pregnant or during your delivery. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
It is not known whether apixaban passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How should I take apixaban?
Apixaban is usually taken twice per day. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
You may take apixaban with or without food.
Apixaban can be given through a nasogastric (NG) feeding tube. Crush the tablet and mix the medicine in a syringe with 60 milliliters of 5% dextrose in water (D5W). Give this mixture right away through the NG tube. Do not save for later use. Do not give this mixture by mouth.
Because apixaban keeps your blood from coagulating (clotting) to prevent unwanted blood clots, this medicine can also make it easier for you to bleed, even from a minor injury such as a fall or a bump on the head. Contact your doctor or seek emergency medical attention if you fall or hit your head, or have any bleeding that will not stop.
If you need surgery or dental work, tell the doctor or dentist ahead of time if you have taken apixaban within the past 24 hours. You may need to stop taking apixaban for a short time before you have surgery or other medical procedures.
Do not stop taking apixaban unless your doctor tells you to. Stopping suddenly can increase your risk of blood clot or stroke.
If you stop taking apixaban for any reason, your doctor may prescribe another medication to prevent blood clots until you start taking apixaban again.
Use apixaban regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Take your next dose the following day and stay on your once-daily schedule. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking apixaban?
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
Apixaban side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;
heavy menstrual periods;
headache, dizziness, weakness, feeling like you might pass out;
red, pink, or brown urine;
black or bloody stools, coughing up blood or vomit that looks like coffee grounds;
numbness, tingling, or muscle weakness (especially in your legs and feet); or
loss of movement in any part of your body.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Apixaban dosing information
Usual Adult Dose for Deep Vein Thrombosis -- Prophylaxis:
5 mg orally twice daily
Approved indication: To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
What other drugs will affect apixaban?
Many drugs can interact with apixaban. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with apixaban, especially:
St. John's wort;
an antibiotic--clarithromycin, rifampin, telithromycin;
antifungal medicine--itraconazole, ketoconazole, posaconazole, voriconazole;
the hepatitis C medications boceprevir or telaprevir;
HIV or AIDS medication--atazanavir, cobicistat (Stribild), fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir; or
seizure medicine--carbamazepine, fosphenytoin, phenobarbital, phenytoin.
Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding, or your risk of developing blood clots around the brain or spinal cord during a spinal tap or epidural. It is very important to tell your doctor about all medicines you have recently used, especially:
dabigatran, dalteparin, enoxaparin, fondaparinux, heparin, tinzaparin, warfarin, Coumadin, Jantoven;
an antidepressant such as citalopram, duloxetine, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, venlafaxine, vilazodone;
an NSAID such as ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others; or
salicylates such as aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others.
These lists are not complete and many other medicines can interact with apixaban. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
More about apixaban
- Other brands: Eliquis
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about apixaban.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
- Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01. Revision Date: 2014-04-13, 7:51:39 PM.