Generic Name: apixaban, Oral tablet

Generic Name:

apixaban, Oral tablet

Eliquis

All Brands

  • Eliquis
SECTION 1 of 5

Highlights for apixaban

Oral tablet
1

Apixaban is an oral drug used to treat and prevent blood clots. It also helps to lower risk of stroke if you have atrial fibrillation without an artificial heart valve.

2

Your dose will depend on your age and the condition that’s being treated.

3

One of the most common side effects is bleeding. This is because apixaban is a blood thinner medication. Some bleeds may be serious and possibly fatal.

4

Apixaban may cause you to bruise more easily. It may also take longer than usual for bleeding to stop. Call your doctor or go to the emergency room right away if you have signs of serious bleeding.

5

Don’t stop taking apixaban without talking to your doctor first. Stopping the drug increases your risk of having a stroke. If you have to stop taking apixaban, your doctor may prescribe another medicine to help keep blood clots from forming.

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Stopping treatment early. Don’t stop taking apixaban without talking to your doctor first. Stopping the drug increases your risk of having a stroke. Apixaban may need to be stopped before a surgery or a medical or dental procedure. Your doctor will tell you how to stop taking it and when you can start taking it again. They may prescribe another medicine to help keep blood clots from forming.

Spinal or epidural blood clot risk. If you take apixaban and have another medicine injected into your spine, or if you have a spinal puncture, you may be at risk for a severe blood clot. A spinal or epidural blood clot could cause you to lose your ability to move permanently. Your risk is higher if:

  • A thin tube called an epidural catheter is placed into your back to give you medicine.
  • You take nonsteroidal anti-inflammatory drugs (NSAIDs) or anticoagulants.
  • You have a history of difficult or repeated epidural or spinal punctures.
  • You have a history of problems with your spine or you’ve had surgery on your spine.

Your doctor will watch you for any signs of spinal or epidural blood clots. Tell your doctor if you have symptoms, such as:

  • tingling, numbness, or muscle weakness, especially in your legs and feet
  • loss of control of your bladder or bowels (incontinence)

Risk of bleeding

Apixaban increases your risk of bleeding. This can be serious or even fatal. This is because apixaban is a blood thinner drug that lowers the risk of blood clots forming in your body.

Artificial heart valve warning

Don’t use apixaban if you have an artificial (prosthetic) heart valve. It isn’t known if apixaban will work for you.

Medical/dental procedure risk

You may need to temporarily stop taking apixaban before a surgery or medical or dental procedure. Your doctor will tell you how to stop taking it and when you can start taking it again. They may prescribe another medicine to help keep blood clots from forming.

Drug Features

Apixaban is a prescription drug. It’s available as an oral tablet.

Why It's Used

Apixaban is used to:

  • lower your risk of blood clots and stroke if you have atrial fibrillation without an artificial heart valve
  • prevent blood clots from forming in your legs (deep vein thrombosis) or lungs (pulmonary embolism) after hip or knee replacement surgery
  • treat deep vein thrombosis or pulmonary embolism
  • prevent another occurrence of deep vein thrombosis (DVT) or pulmonary embolism (PE) in people with a history or DVT or PE.

How It Works

Apixaban belongs to a class of drugs called anticoagulants, specifically factor Xa blockers. It prevents blood clots from forming in your body by blocking a particular substance.

Apixaban is a blood thinner. It helps to prevent blood clots from forming in your body by blocking the substance factor Xa. This is a blood-clotting factor that’s needed for your blood to clot. Block factor Xa decreases the amount of the enzyme thrombin. Thrombin is a substance in your blood that’s needed to form clots. Thrombin also causes platelets in your blood to stick to one another, causing clots to form. When thrombin is decreased, this prevents a clot (thrombus) from forming in your body.

SECTION 2 of 5

apixaban Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with apixaban include:

  • bleeding. Symptoms may include:

    • nosebleeds
    • bruising more easily
    • heavy menstrual bleeding
    • bleeding of your gums when you brush your teeth

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • serious bleeding. Serious bleeding events include coughing up blood or blood in your stomach, intestines, eyes, brain, rectum, or urine. Some of these bleeds could be deadly. Signs include:
    • unexpected bleeding or bleeding that lasts a long time. This includes unusual bleeding from your gums, nosebleeds that happen often, or heavy menstrual bleeding .
    • bleeding that is severe or uncontrollable
    • red, pink, or brown-colored urine
    • Red or black-colored, tarry stools
    • coughing up blood or blood clots
    • vomiting blood or vomit that looks like coffee grounds
    • unexpected pain or swelling
    • headaches, dizziness, or weakness
  • spinal or epidural blood clots (hematoma). If you take apixaban and have another medicine injected into your spine, or if you have a spinal puncture, you may be at risk of a spinal or epidural blood clot. This can lead to permanent paralysis. Symptoms include:
    • tingling, numbness, or muscle weakness, especially in your legs and feet
    • loss of control of your bladder or bowels (incontinence)
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Apixaban does not cause drowsiness.

Mild side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

apixaban May Interact with Other Medications

Oral tablet

Apixaban can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Anticoagulant or antiplatelet drugs
  • warfarin
  • heparin
  • aspirin
  • clopidogrel
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen

Using apixaban with other drugs from the same class increases your risk of bleeding.

Drugs that inhibit CYP3A4 and P-glycoprotein
  • ketoconazole
  • itraconazole
  • ritonavir
  • clarithromycin

Apixaban is processed by certain enzymes in your liver (known as CYP3A4) and transporters in the gut (known as P-gp). Medications that block these enzymes and transporters increase the amount of apixaban in your body. This puts you at greater risk for bleeding. Your doctor may lower your dose of apixaban or prescribe a different drug.

Drugs that induce CYP3A4 and P-glycoprotein
  • rifampin
  • carbamazepine
  • phenytoin
  • St. John’s Wort

Apixaban is processed by certain enzymes in your liver (known as CYP3A4) and transporters in the gut (known as P-gp). Medications that increase the activity of these liver enzymes and gut transporters decrease the amount of apixaban in your body. This puts you at greater risk for stroke or other blood-clotting events. You shouldn’t take apixaban with these medications.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with liver problems

If you have severe liver problems, you shouldn’t take apixaban. This drug is processed by your liver. If your liver isn’t working well, more of the drug may stay in your body. This puts you at risk for more side effects.

People with kidney problems

If you have severe kidney problems, you may need a lower dose of this drug. If your kidneys aren’t working well, more of the drug may stay in your body. This puts you at risk for more side effects.

People with active bleeding

If you’re bleeding or losing blood, you shouldn’t take apixaban. It may increase your risk of serious or fatal bleeding.

Pregnant women

Apixaban is a pregnancy category B drug. That means two things:

  1. Studies of the drug in pregnant animals have not shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Apixaban should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Women who are nursing

No reports describe apixaban passing through the breast milk, but its chemical structure suggests that it will pass through breast milk. If it does, it may cause serious effects in a breastfeeding child. The safest thing to do is not to breastfeed if you’re taking apixaban.

You and your doctor may need to decide if you’ll take apixaban or breastfeed.

For Seniors

In general, as you age, your organs, such as your kidneys, may not work as well as they once did. This can increase your risk of side effects from this medication since your kidney may not get rid of the medications as easily as before.

For Children

The safety and effectiveness of apixaban haven’t been established in people under the age of 18.

Keep apixaban and other drugs out of the reach of children.

When to call the doctor

  • Call your doctor right away if you fall or hurt yourself, especially if you hit your head. Your doctor may need to check if you’re bleeding inside your body.
  • If you plan to have surgery or a medical or a dental procedure, tell your doctor or dentist that you’re taking apixaban. You may have to stop taking it for a short time. Your doctor will tell you how to stop taking it and when you can start taking it again. They may prescribe another medicine to help keep blood clots from forming.

Allergies

Apixaban can cause a severe allergic reaction. Symptoms may include:

  • chest pain or tightness
  • swelling of your face or tongue
  • trouble breathing or wheezing
  • feeling dizzy or faint

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 5

How to Take apixaban (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Reduce the risk of stroke and blood clots in people with atrial fibrillation

Brand: Eliquis

Form: Oral tablet
Strength: 2.5 mg and 5 mg
Adult Dosage (18–79 years)

The recommended dose is 5 mg taken two times per day.

Child Dosage (ages 0–17 years)

A safe and effective dose hasn’t been established for this age group.

Senior Dosage (80 years and older)

If you have severe kidney problems or weigh less than or equal to 132 pounds (60 kg), your doctor may lower your dose. If your kidneys aren’t working well, more of the drug may stay in your body. This puts you at risk for more side effects.

Special Considerations

Kidney problems: If your kidneys aren’t working well, more of the drug may stay in your body. This puts you at risk for more side effects.

  • If you have severe kidney problems and are on dialysis, your dose should be 5 mg taken two times per day.
  • If you're age 80 years or older or if you weigh less than 132 pounds (60 kg), the dose should be 2.5 mg taken twice per day.

Low body weight: If you weigh less than or equal to 132 pounds (60 kg), and have one of the following characteristics, the recommended dose is 2.5 mg taken two times per day:

  • age 80 or older
  • kidney problems

Warnings

  • If you’re having any surgery or a procedure that has a moderate or high risk of significant bleeding, your doctor will have you stop taking apixaban at least 48 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.
  • If you’re having any surgery or procedure that has a low risk of bleeding or where bleeding could be controlled, your doctor will have you stop taking apixaban at least 24 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.

Reduce the risk of blood clots in people who have just had hip or knee replacement surgery

Brand: Eliquis

Form: Oral tablet
Strength: 2.5 mg and 5 mg
Adult Dosage (18 years and older)
  • The recommended dose is 2.5 mg taken two times per day.
  • You should take your first dose 12–24 hours after surgery.
  • For hip surgery, your treatment with apixaban will last 35 days.
  • For knee surgery, your treatment with apixaban will last 12 days.
Child Dosage (ages 0–17 years)

A safe and effective dose hasn’t been established for this age group.

Warnings

  • If you’re having any surgery or a procedure that has a moderate or high risk of significant bleeding, your doctor will have you stop taking apixaban at least 48 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.
  • If you’re having any surgery or procedure that has a low risk of bleeding or where bleeding could be controlled, your doctor will have you stop taking apixaban at least 24 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.

Deep vein thrombosis and pulmonary embolism

Brand: Eliquis

Form: Oral tablet
Strength: 2.5 mg and 5 mg
Adult Dosage (18 years and older)

The dose is 10 mg taken two times per day for 7 days followed by 5 mg taken two times per day for at least 6 months.

Child Dosage (ages 0–17 years)

A safe and effective dose hasn’t been established for this age group.

Warnings

  • If you’re having any surgery or a procedure that has a moderate or high risk of significant bleeding, your doctor will have you stop taking apixaban at least 48 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.
  • If you’re having any surgery or procedure that has a low risk of bleeding or where bleeding could be controlled, your doctor will have you stop taking apixaban at least 24 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.

Reduce the risk of deep vein thrombosis and pulmonary embolism

Brand: Eliquis

Form: Oral tablet
Strength: 2.5 mg and 5 mg
Adult Dosage (18 years and older)

The recommended dose is 2.5 mg taken two times per day. You should take this treatment for 6 months after deep vein thrombosis or pulmonary embolism.

Child Dosage (ages 0–17 years)

A safe and effective dose hasn’t been established for this age group.

Warnings

  • If you’re having any surgery or a procedure that has a moderate or high risk of significant bleeding, your doctor will have you stop taking apixaban at least 48 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.
  • If you’re having any surgery or procedure that has a low risk of bleeding or where bleeding could be controlled, your doctor will have you stop taking apixaban at least 24 hours before the procedure. Your doctor will tell you when it’s okay to start taking the drug again.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Apixaban comes with serious risks if you don’t take it as prescribed.

If You Miss a Dose

If you miss a dose, take it as soon as you remember on the same day. Then go back to your normal schedule. Don’t take more than one dose of apixaban at a time to try to make up for a missed dose.

If You Stop Taking It

Stopping apixaban may increase your risk of a stroke or blood clots. Be sure to refill your prescription before you run out. If you plan to have surgery or a medical or dental procedure, tell your doctor or dentist that you’re taking apixaban. You may need to temporarily stop taking it.

If You Take Too Much

If you take more than your prescribed dose of apixaban, you have a greater risk of bleeding. This can be serious and even fatal. Apixaban doesn’t have FDA approved antidotes like other medications. If you think that you’ve taken too much apixaban, call your doctor or go to the emergency room right away.

How to Tell the Drug Is Working

When using the drug to reduce the risk of blood clots, you may not be able to tell if the drug is working. The medication was designed so you wouldn’t have to get routine tests to see if it’s working. Your doctor may do tests to check apixaban blood levels, but this isn’t very common.

For treating deep vein thrombosis and pulmonary embolism, You may be able to tell it’s working if your symptoms improve.

Apixaban may be used for short-term or long-term treatment.

Your doctor will decide how long you should take apixaban. Don’t stop taking it without talking with your doctor first.

Important Considerations for Taking Apixaban

Don’t cut or crush the tablets

Tell your doctor if you’re unable to swallow whole tablets. Your doctor may crush apixaban, mix it in a dextrose water solution, and give you the drug through a tube that goes through your nose.

Store at room temperature: 68–77°F (20–25°C)

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s label to identify the medication. Keep the original prescription label with you when traveling.

Clinical Monitoring

Your doctor may check the following during your treatment:

  • kidney function. Your doctor may do blood tests to check how well your kidneys are working. If you have kidney problems, your body won’t be able to clear out the drug as well. This could cause more apixaban to stay in your body, which will increase your risk for side effects.
  • liver function. Your doctor may do blood tests to check how well your liver is working. If your liver isn’t working well, more of the drug may stay in your body. This puts you at risk for more side effects.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for apixaban.

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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SECTION 5 of 5

How Much Does apixaban Cost?

Oral tablet
We've partnered with GoodRX so you can compare prices and save money on your next prescription. Check out the lowest cash prices below and enter your zip code to find the best deal near you.

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Lowest price for apixaban

Membership warehouse $326.24
Publix $327.49
Kroger Pharmacy $327.50
These represent the lowest cash prices for apixaban and may be lower than your insurance.

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These represent the lowest cash prices for apixaban and may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on June 12, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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