Apixaban Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 18, 2023.

Applies to apixaban: oral tablet.

Precautions

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Make sure any doctor who treats you knows that you are using this medicine. You may need to stop using this medicine for several days before having surgery, including dental procedures.

Do not suddenly stop using this medicine without asking your doctor. You might have a higher risk of stroke after you stop using this medicine.

You may bleed and bruise more easily while you are using this medicine. Be extra careful to avoid injuries. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Gently brush and floss your teeth. Be careful when using sharp objects, including razors and fingernail clippers. Avoid picking your nose. If you need to blow your nose, blow it gently.

Check with your doctor right away if you have any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, headache, dizziness, or weakness, pain, swelling, or discomfort in a joint, pinpoint red spots on your skin, unusual nosebleeds, or unusual vaginal bleeding that is heavier than normal. These may be signs of bleeding problems.

This medicine may increase risk of blood clot in the spine or epidural area, which may lead to long-term or permanent paralysis. This is more likely to occur if you have an epidural catheter placed in your back, are taking NSAID or blood clotting medicine, a history of repeated epidural punctures or problems with your spine, or have had surgery on your spine. Tell your doctor right away if you have tingling, numbness, or muscle weakness, especially in your legs and feet.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

Serious side effects of apixaban

Along with its needed effects, apixaban may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking apixaban:

For healthcare professionals

Applies to apixaban: oral powder for reconstitution, oral tablet, oral tablet dispersible.

General adverse events

The most common adverse events were related to bleeding. Common adverse reactions were anemia, hemorrhage, and nausea.^[Ref]

Hematologic

• Very common (10% or more): Minor bleed (11.7%)
• Common (1% to 10%): Anemia postoperative, clinically relevant nonmajor bleed, hemoglobin decreased, anemia, hemorrhage
• Uncommon (0.1% to 1%): Postprocedural hemorrhage, hemoglobin decrease of 2 g/dL or more, transfusion of 2 units or more red blood cells, fatal bleed, thrombocytopenia, hemorrhagic anemia
• Rare (less than 0.1%): Bleed at critical site^[Ref]

Patients with diabetes had more bleeding events than non-diabetic subjects. Hemorrhage includes hematoma, and vaginal and urethral hemorrhage. Postprocedural hemorrhage includes postprocedural hematoma, wound hemorrhage, vessel puncture site hematoma, and catheter site hemorrhage.^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (14.1%)
• Common (1% to 10%): Constipation, vomiting, diarrhea, abdominal pain upper, abdominal pain, dyspepsia, gastritis, gastroenteritis, toothache, gingival bleeding, rectal hemorrhage, dyspepsia, gastrointestinal hemorrhage (including hematemesis and melena),
• Uncommon (0.1% to 1%): Major gastrointestinal bleed, hematochezia, hemorrhoidal hemorrhage, hematemesis, melena, anal hemorrhage, occult blood positive, occult blood, intra-abdominal hemorrhage, mouth hemorrhage
• Rare (less than 0.1%): Retroperitoneal hemorrhage^[Ref]

Cardiovascular

• Common (1% to 10%): Hypotension, peripheral edema, atrial fibrillation, cardiac failure, hypertension, deep vein thrombosis, tachycardia, cardiac failure congestive, palpitations, thrombosis, angina pectoris, bradycardia, blood pressure increased, procedural hypotension, unstable angina, tachycardia^[Ref]

Nervous system

• Common (1% to 10%): Dizziness, headache, fatigue, syncope, ischemic stroke, vertigo
• Uncommon (0.1% to 1%): Somnolence, cerebrovascular accident, transient ischemic attack, major intracranial bleed, brain hemorrhage, other intracranial or intraspinal hemorrhage (including subdural hematoma, subarachnoid hemorrhage, and spinal hematoma)
• Frequency not reported: Stroke^[Ref]

Local

• Common (1% to 10%): Hematoma, wound hemorrhage, wound secretion
• Uncommon (0.1% to 1%): Incision-site hemorrhage, operative hemorrhage, traumatic hematoma, injection site hematoma, vessel puncture site hematoma, application site bleeding, traumatic hemorrhage^[Ref]

Ocular

• Common (1% to 10%): Cataract, conjunctival hemorrhage, eye hemorrhage
• Uncommon (0.1% to 1%): Major intraocular bleed, periorbital hematoma, conjunctival hemorrhage, retinal hemorrhage
• Frequency not reported: Ocular hemorrhage^[Ref]

Respiratory

• Common (1% to 10%): Nasopharyngitis, dyspnea, epistaxis, bronchitis, cough, upper respiratory tract infection, influenza, pneumonia, sinusitis, chronic obstructive pulmonary disease, lower respiratory tract infection, hemoptysis, dyspnea exertional, respiratory tract infection
• Uncommon (0.1% to 1%): Dyspnea
• Rare (less than 0.1%): Pulmonary embolism, respiratory tract hemorrhage (including pulmonary alveolar hemorrhage, laryngeal hemorrhage, and pharyngeal hemorrhage)^[Ref]

Other

• Very common (10% or more): Procedural pain (10.3%)
• Common (1% to 10%): Pyrexia, chest pain, fall, asthenia, blood creatine phosphokinase increased, pain, body temperature increased, laceration, chest discomfort, tooth extraction
• Uncommon (0.1% to 1%): Herpes zoster^[Ref]

Genitourinary

• Common (1% to 10%): Urinary tract infection, menorrhagia
• Uncommon (0.1% to 1%): vaginal hemorrhage, metrorrhagia, menometrorrhagia, genital hemorrhage, blood urine present, red blood cells urine positive, abnormal vaginal hemorrhage, urogenital hemorrhage^[Ref]

Renal

• Common (1% to 10%): Hematuria, blood creatinine increased, renal failure^[Ref]

Musculoskeletal

• Common (1% to 10%): Arthralgia, back pain, pain in extremity, osteoarthritis, muscle spasms, musculoskeletal pain, myalgia, arthritis
• Uncommon (0.1% to 1%): Muscle hemorrhage, joint swelling^[Ref]

Metabolic

• Common (1% to 10%): Gout, diabetes mellitus, blood glucose increased, hyperglycemia, hypokalemia, decreased appetite^[Ref]

Hypersensitivity

• Uncommon (0.1% to 1%): Hypersensitivity (including drug hypersensitivity such as skin rash and anaphylactic reaction such as allergic edema)^[Ref]

Hepatic

• Uncommon (0.1% to 1%): Transaminases increased, AST increased, ALT increased, gamma-glutamyl transferase increased, liver function test abnormal, blood alkaline phosphatase increased, blood bilirubin increased^[Ref]

Psychiatric

• Common (1% to 10%): Insomnia, depression
• Uncommon (0.1% to 1%): Anxiety^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus, contusion, rash, cellulitis, ecchymosis, erythema, blister
• Uncommon (0.1% to 1%): Skin hemorrhage, petechiae, skin rash^[Ref]

Oncologic

• Uncommon (0.1% to 1%): Basal cell carcinoma^[Ref]

See also:

Frequently asked questions

• Xarelto vs Eliquis: How do they compare?
• How do you reverse bleeding with Xarelto?
• What are biologic drugs and how do they work?

Further information

Apixaban side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer