apixaban

Pronunciation: a PIX a ban

Brand: Eliquis

What is the most important information I should know about apixaban?

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. Avoid activities that may increase your risk of bleeding or injury. Contact your doctor or seek emergency medical attention if you have bleeding that will not stop.

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Call your doctor at once if you have any signs of bleeding such as weakness, feeling like you might pass out, easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin, pink or brown urine, bloody or tarry stools, coughing up blood, joint pain or swelling, or heavy menstrual bleeding.

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Tell any doctor or dentist who treats you that you are using apixaban. If you need surgery or dental work, you may need to stop using the medicine for a short time.

Some drugs can raise or lower your blood levels of apixaban, which may cause side effects or make apixaban less effective. Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding or life-threatening blood clots. It is very important to tell your doctor about all medicines you have recently used.

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Do not stop taking apixaban without first talking to your doctor. Stopping suddenly can increase your risk of blood clot or stroke.

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 may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking apixaban?

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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:

  • kidney disease;
  • liver disease;
  • if you are older than 80; or
  • if you weigh less than 132 pounds.

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.

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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.

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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.

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Do not stop taking this medication without first talking to your doctor. 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.

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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?

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Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking apixaban?

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Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

What are the possible side effects of apixaban?

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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.

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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.

What other drugs will affect apixaban?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with apixaban, especially:

  • bosentan;
  • conivaptan;
  • cyclosporine;
  • imatinib;
  • isoniazid, rifabutin, rifampin, rifapentine;
  • nefazodone;
  • St. John's wort;
  • an antibiotic--azithromycin, clarithromycin, erythromycin, nafcillin, telithromycin;
  • antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;
  • heart or blood pressure medication--amiodarone, captopril, carvedilol, diltiazem, dronedarone, felodipine, nicardipine, quinidine, ranolazine, verapamil;
  • the hepatitis C medications boceprevir or telaprevir;
  • HIV or AIDS medication--atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir, tipranavir; or
  • seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone.
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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:

  • dextran;
  • abciximab, eptifibatide, ticagrelor, tirofiban;
  • alteplase, reteplase, tenecteplase, urokinase;
  • anagrelide, cilostazol, clopidogrel, dipyridamole, eltrombopag, oprelvekin, prasugrel, romiplostim, ticagrelor, ticlopidine;
  • argatroban, bivalirudin, dabigatran, lepirudin, rivaroxaban;
  • dalteparin, enoxaparin, fondaparinux, heparin, tinzaparin, warfarin, Coumadin;
  • an antidepressant such as citalopram, duloxetine, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, venlafaxine, vilazodone;
  • an NSAID (non-steroidal anti-inflammatory drug) 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.

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.

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