Apixaban

apixaban

Brand(s):

• Eliquis

Manufacturer:

• Pfizer

Disease(s):

• Blood Clots / Deep Vein Thrombosis

Apixaban Tablets

What is Apixaban?

Apixaban is a medication used to prevent blood clots. Specifically, it's prescribed to reduce the risk of stroke in individuals with atrial fibrillation (a heart rhythm disorder). It also plays a crucial role in preventing deep vein thrombosis (DVT) – a blood clot that forms in a deep vein, often after hip or knee replacement surgery. DVTs can be dangerous, potentially leading to pulmonary embolism (PE), where a blood clot travels to the lungs. Beyond prevention, apixaban is also used to treat existing DVTs and PEs, as well as to lower the chance of them recurring. While effective, it's important to remember that apixaban, like any medication, has potential side effects and shouldn't be taken without a doctor's prescription.

Warnings

A significant risk associated with apixaban is increased bleeding, which can range from minor bruising to severe, even fatal, hemorrhaging. This risk is heightened when apixaban is combined with certain other medications, both prescription and over-the-counter. Always inform your doctor of all medications you are currently taking or have recently used.

Seek immediate medical attention if you experience any of the following bleeding signs: easy bruising, unusual bleeding (from any part of the body), unexpected pain or swelling, feeling faint or dizzy, bleeding gums, nosebleeds, heavy menstrual bleeding, blood in urine or stool, coughing up blood, or vomit resembling coffee grounds. Any bleeding that doesn't stop needs prompt medical help.

Another serious risk is the potential for a blood clot to form around the spinal cord. This can lead to permanent paralysis. This risk is amplified if you're undergoing a spinal tap or epidural anesthesia, especially if you have pre-existing spinal conditions (such as a genetic spinal defect), have used a spinal catheter, have a history of spinal surgery or multiple spinal taps, or if you're on other blood-thinning medications. Contact emergency services immediately if you experience symptoms such as tingling, numbness, or muscle weakness, particularly in your legs and feet.

Never stop taking apixaban without your doctor's explicit instructions. Sudden cessation can significantly increase your risk of stroke or blood clot formation.

Before Taking Apixaban

Apixaban is not suitable for everyone. You shouldn't take it if you're allergic to apixaban or if you have active bleeding from an injury or surgery. Because apixaban increases bleeding risk, it's particularly important to disclose any pre-existing bleeding disorders to your physician.

Inform your doctor if you have or have ever had:

• Bleeding problems
• Antiphospholipid syndrome (especially with a triple-positive antibody test)
• Liver or kidney disease
• An artificial heart valve

The risk of a spinal cord blood clot is increased under specific circumstances, including:

• Presence of a spinal catheter (or recent removal)
• History of spinal surgery or multiple spinal taps
• Recent spinal tap or epidural anesthesia
• Use of aspirin or other NSAIDs (like ibuprofen, naproxen, diclofenac, etc.)
• Use of other blood clot prevention or treatment medications

Pregnancy and childbirth also warrant caution. Apixaban may increase bleeding risks during pregnancy or delivery. Discuss its use during pregnancy or if you plan to become pregnant with your doctor. Breastfeeding is not recommended while taking apixaban.

How to Take Apixaban

Always follow your doctor's instructions and the information provided on your prescription label. Your dosage might be adjusted over time. Apixaban can be taken with or without food. If swallowing the tablet whole is difficult, crush it and mix it with water, apple juice, or applesauce. Consume the mixture immediately without chewing. Crushed tablets can also be administered through a nasogastric (NG) tube, but follow the instructions carefully.

Be mindful that apixaban increases bleeding susceptibility. Even minor injuries could lead to prolonged bleeding. Seek medical assistance if bleeding persists. Inform your doctor about any planned surgeries or dental procedures as you might need to temporarily discontinue apixaban. Remember, never stop taking apixaban unless your doctor advises you to do so. If you stop, alternative blood clot prevention medications may be prescribed.

Store apixaban at room temperature, away from moisture and heat.

Missed Dose

If you miss a dose, take it as soon as you remember, but only if it's still the same day. Resume your regular twice-daily schedule. Avoid doubling up on doses. Ensure you refill your prescription before you run out.

Things to Avoid While on Apixaban

Minimize activities that increase the risk of bleeding or injury. Exercise caution when shaving or brushing your teeth.

Apixaban Side Effects

Seek immediate medical attention for allergic reactions (hives, chest pain, wheezing, difficulty breathing, lightheadedness, swelling of face, lips, tongue, or throat) and signs of a spinal blood clot (tingling, numbness, muscle weakness, especially in legs and feet).

Contact your doctor promptly if you experience:

• Easy bruising, unusual bleeding (nosebleeds, mouth, vagina, or rectum), bleeding from wounds or injections, or any bleeding that won't stop.
• Heavy menstrual bleeding
• Headache, dizziness, weakness, or feeling faint
• Red, pink, or brown urine
• Black or bloody stools, or coughing up blood or vomit resembling coffee grounds.

This isn't an exhaustive list of potential side effects.

Drug Interactions

Certain medications should not be taken concurrently with apixaban. Some drugs can alter apixaban's blood levels, leading to increased side effects or reduced effectiveness. Many medications (including over-the-counter options) can increase the risk of bleeding or blood clots. Always inform your doctor about all medications you're taking, especially:

• Other blood clot prevention or treatment medications
• Blood thinners like heparin or warfarin
• Antidepressants
• Long-term use of aspirin or other NSAIDs

This list isn't comprehensive; numerous other drugs could interact with apixaban, including prescription medications, over-the-counter drugs, vitamins, and herbal supplements. This information is not a substitute for professional medical advice. Always consult your doctor or pharmacist before starting or changing any medication.