You will have been prescribed apixaban either to treat a harmful clot that has formed in a blood vessel, or to prevent one from forming.
The usual dose is one tablet taken twice a day, morning and evening.
The most common side-effects are bleeding (such as nosebleeds) and anaemia.
|Type of medicine||A factor Xa inhibitor anticoagulant|
|Used for||To prevent or treat harmful blood clots|
|Also called (UK and USA)||Eliquis®|
Apixaban works by preventing your blood from clotting as quickly or as effectively as normal. It does this by blocking a substance in your blood, called 'factor Xa', which is involved in the development of blood clots.
Sometimes, harmful blood clots can form in the blood vessels of your legs, lungs, brain or heart, and cause a blockage. This is more likely to happen if you have had surgery, or if you have a fast irregular heartbeat. For many years, a medicine called warfarin has been commonly used to help protect against this. However, people who take warfarin need to have regular blood tests to measure how quickly their blood clots. This often means that the dose of warfarin can change quite frequently. Apixaban works in a slightly different way to warfarin, so people who take apixaban do not need to have regular blood tests.
Apixaban is prescribed to treat blood clots causing deep vein thrombosis and pulmonary embolism. You may also be prescribed apixaban to help protect against recurrent blood clots, or if you have a certain type of irregular fast heartbeat known as atrial fibrillation.
Before taking apixaban
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking apixaban it is important that your doctor knows:
- If you are pregnant or breastfeeding.
- If you have any medical problems that increase your risk of bleeding, or if you have recently had surgery.
- If you have any problems with the way your liver works, or with the way your kidneys work.
- If you have been told you have a condition called antiphospholipid syndrome.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take apixaban tablets
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about apixaban and will provide you with a full list of the side-effects which you could experience from taking it.
- Take apixaban exactly as your doctor tells you to. It is taken twice a day, preferably in the morning and the evening. Your doctor or pharmacist will tell you which strength of tablet is right for you as there are two strengths of apixaban available - 2.5 mg and 5 mg. This information will also be printed on the label of the pack to remind you.
- Apixaban can be taken either with or without food. Swallow the tablet with a drink of water. If you have difficulty swallowing the tablet whole, you can crush the tablet and then mix it with 30 ml (two tablespoons) of water or apple juice, or alternatively, add it to some apple purée. Swallow the mixture as soon as it has been made up.
- If you forget to take a dose at the usual time, take it as soon as you remember. Try to take the correct number of doses each day, but do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep any regular appointments with your doctor. This is so your doctor can check on your progress.
- The length of the course of treatment will depend upon why you are taking the tablets, but it will either be for a few weeks, or long-term. If you have had hip or knee surgery, you will be asked to continue taking apixaban for a certain number of weeks. If you are taking it to protect you from blood clots developing (such as if you have atrial fibrillation), you will be asked to continue to take it over a longer period of time.
- If you take any medicines that you have bought without a prescription, check with a pharmacist that they are suitable to take with apixaban. This is because some medicines, such as aspirin and some anti-inflammatory painkillers, can interfere with it.
- If you are due to have an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking. This is because it may become necessary for you to stop taking apixaban for a day or so.
Can apixaban tablets cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with apixaban. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common apixaban side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Bleeding (such as nosebleeds) or bruising||If this continues or becomes troublesome, let your doctor know|
|Anaemia (which could make you feel very tired)||Your doctor will check for this|
|Feeling sick (nausea)||Try taking your doses with something to eat|
Important: if you experience any unusual bleeding, or bleeding that doesn't stop within ten minutes, speak with your doctor straightaway or go to your local accident and emergency department.
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store apixaban
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Eliquis® 2.5 mg film-coated tablets; Bristol-Myers Squibb-Pfizer, The electronic Medicines Compendium. Dated October 2019.
Manufacturer's PIL, Eliquis® 5 mg film-coated tablets; Bristol-Myers Squibb-Pfizer, The electronic Medicines Compendium. Dated October 2019.
British National Formulary, 78th Edition (Sep 2019); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.