Apixaban is used to prevent serious blood clots from forming due to a certain irregular heartbeat (atrial fibrillation) or after hip/knee replacement surgery. With atrial fibrillation, part of the heart does not beat the way it should. This can
lead to blood clots forming, which can travel to other parts of your body (such as the lungs or legs) or increase your risk for stroke. In the United States, apixaban is also approved to treat certain types of blood clots (deep vein
thrombosis-DVT, pulmonary embolus-PE) and to prevent them from forming again.
Apixaban is an anticoagulant that works by blocking certain clotting proteins in your blood.
Take this medication by mouth with or without food as directed by your doctor, usually twice daily (every 12 hours). The dosage is based on your medical condition, age, weight, kidney function, response to treatment, and other
medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). If you are taking apixaban to prevent blood clots
from forming after surgery, the length of treatment is based on the type of surgery that you had.
Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Do not run out of this medication. Order your refills early to avoid running out of pills.
POSSIBLE SIDE EFFECTS
Nausea, easy bruising, or minor bleeding (such as nosebleed, bleeding from cuts) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This medication can cause serious bleeding if it affects your blood clotting proteins too much. Tell your doctor right away if you have any signs of serious bleeding, including: unusual pain/swelling/discomfort, unusual bruising,
prolonged bleeding from cuts or gums, persistent/frequent nosebleeds, unusually heavy/prolonged menstrual flow, pink/dark urine, coughing up blood, vomit that is bloody or looks like coffee grounds, severe headache,
dizziness/fainting, unusual or persistent tiredness/weakness, bloody/black/tarry stools, difficulty swallowing.
PRECAUTIONS
Before taking apixaban, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your
pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, bleeding problems (such as bleeding of the stomach/intestines, bleeding in the brain), blood disorders (such
as anemia, hemophilia, thrombocytopenia), recent major injury/surgery, stroke, frequent falls/injuries.
Before having surgery or any medical/dental procedures (especially spinal puncture or spinal/epidural anesthesia), tell your doctor or dentist that you are taking this medication and about all the products you use (including prescription
drugs, nonprescription drugs, and herbal products). Your doctor or dentist may tell you to stop taking apixaban before your surgery. Ask for specific instructions about stopping or starting this medication.
This medication may cause stomach bleeding. Daily use of alcohol while using this medicine will increase your risk for stomach bleeding. Limit alcoholic beverages. Ask your doctor or pharmacist about how much alcohol you may
safely drink.
This medication can cause bleeding. To lower the chance of getting cut, bruised, or injured, use great caution with sharp objects like safety razors and nail cutters. Use an electric razor when shaving and a soft toothbrush when
brushing your teeth. Avoid activities such as contact sports. If you fall or injure yourself, especially if you hit your head, contact your doctor right away. Your doctor may need to check you for hidden bleeding that could be serious.
This medication is not recommended for use during pregnancy. Consult your doctor for more details.
It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
INTERACTIONS
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including
prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: mifepristone, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, "blood thinners" such as warfarin, enoxaparin), certain
antidepressants (including SSRIs such as fluoxetine, SNRIs such as venlafaxine).
Other medications can affect the removal of apixaban from your body, which may affect how apixaban works. Examples include certain azole antifungals (such as itraconazole, ketoconazole, posaconazole), clarithromycin, conivaptan,
HIV protease inhibitors (such as lopinavir, ritonavir), rifamycins (such as rifabutin), St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen, naproxen) that may increase your risk for bleeding if taken together
with this medication. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor
instructs you otherwise. Ask your doctor or pharmacist for more details.