Apixaban: Uses, Dosage, Side Effects, and Precautions

Apixaban is a prescription drug that comes in the form of an oral tablet. It is available in the brand name drug called Eliquis. The medication is used for lowering the risk of blood clots and stroke if you are having atrial fibrillation without an artificial heart valve. This medicine is available in the following dosage forms of tablet

Apixaban belongs to the class of drugs called anticoagulants factor Xa blockers. The medication is a blood thinner and helps in preventing blood clots from forming in the body. It does this by blocking the substance factor Xa which in turn decreases the amount of enzyme thrombin in the blood.

What Are the Uses of Apixaban Tablet?

Apixaban tablet uses to prevent strokes and blood clots in people with atrial fibrillation not caused by heart valve disease. The medication works by blocking the action of certain natural substances that promote blood clot formation. Apixaban is prescribed to reduce the risk of DVT and PE in various clinical settings.

Conditions Apixaban Treats

• Deep Vein Thrombosis (DVT)
• Pulmonary Embolism (PE)
• Nonvalvular Atrial Fibrillation (to reduce stroke risk)
• Post-surgical clot prevention (hip/knee replacement)

Secondary Benefits of Apixaban

Though mainly for clot prevention, it may also be used in:

• Extended treatment of DVT or PE to prevent recurrence
• Off-label use in some cases for patients with high clotting risk under doctor supervision

How Does Apixaban Work?

Apixaban works by blocking a clotting protein in the blood called Factor Xa. This stops the blood from forming harmful clots without breaking down existing ones. It's part of a group of medicines called direct oral anticoagulants (DOACs).

Mechanism of Action

When your body needs to form a blood clot (like after a cut), several proteins work together in a chain reaction. One of the key proteins is Factor Xa. Apixaban blocks Factor Xa, which slows down the clotting process, making your blood flow more freely and reducing the risk of dangerous clots like in the lungs or brain.

Does Apixaban Interact with Hormones or the Nervous System?

• Hormone interaction: Apixaban does not directly affect hormones like estrogen, insulin, or thyroid hormones.
• Nervous system action: Apixaban does not act on the brain or nervous system. It strictly works in the bloodstream to prevent clots.

Dosage of Apixaban

Drug form and strengths

• Brand: Eliquis
• Form: oral tablet
• Strengths: 2.5 mg and 5 mg

Adult dosage for:

• Reducing stroke and blood clots - 5 mg tablet should be taken 2 times per day
• Reduce the risk of blood clots - 2.5 mg tablet should be taken 2 times per day
• Reducing the risk of deep vein thrombosis and pulmonary embolism - 2.5 mg tablet should be taken 2 times per day

What Should I Do If I Miss a Dose?

Missing one or two-dose of Apixaban won't show any effect on your body. The skipped dose causes no problem. But with some medication, it won't work if you don't take the dosage on time. If you miss a dose some sudden chemical change may affect your body. In some cases, your doctor would advise you to take the prescribed medicine as soon as possible if you have missed the dose.

What happens if an Overdose?

Overdose of a drug can be accidental. If you have taken more than the prescribed Apixaban tablets there is a chance of getting a harmful effect on your body's functions. Overdose of a medicine can lead to some medical emergency.

Symptoms of Apixaban Overdose

• Unusual or prolonged bleeding (from gums, nose, or cuts)
• Easy or severe bruising
• Blood in urine or stools (red or black/tarry stools)
• Vomiting blood or material that looks like coffee grounds
• Dizziness or fainting (due to blood loss)
• Headaches or confusion (could indicate internal bleeding in the brain)

If an overdose is suspected, seek immediate medical help. Treatment may include stopping the drug, giving activated charcoal, or using a reversal agent like andexanet alfa in emergencies.

What are the Side Effects of Apixaban?

Some of the common side effects of Apixaban

Bleeding. It includes some symptoms such as:

• Nose bleeds
• Heavy menstrual bleeding
• Bleeding of gums while brushing

Some of the serious side effects of Apixaban

Serious bleeding. It includes some symptoms like:

• Unexpected bleeding
• Bleeding that is severe
• Blood vomiting
• Unexpected pain
• Headaches

Spinal or epidural blood clots. It includes symptoms like:

• Tingling
• Numbness
• Muscle weakness

If you have any of these serious symptoms immediately contact your doctor for further assistance. In any case, due to Apixaban if you get any kind of reactions in your body try avoiding it.

A doctor advised you to take the medicines by seeing your problems and the benefits of this medicine is greater than the side effects. Majority of the people who use this medicine don't show any side effects. Get medical help immediately if you get any serious Apixaban side effects.

Precautions and Warnings

Before taking Apixaban talk to your doctor if you are allergic to it or any other medication. The product may contain some inactive ingredient that can cause some serious allergic reaction or problem to your body.

Conditions Where Caution Is Needed

Before using the medication talk to your doctor if you are having any of the medical history such as:

• Liver disease
• Kidney disease
• Bleeding problems
• Blood disorders
• Major surgery
• Stroke
• Clotting disorder

Talk to your doctor if you have a heart valve or if you have heavy bleeding anywhere in the body which can't be stopped.

Who Should Avoid Apixaban?

• Pregnant or breastfeeding women (unless specifically advised by a doctor)
• Children's or adolescents safety is not established for people under 18
• People with active bleeding disorders
• Those with severe liver problems affecting blood clotting
• Patients allergic to apixaban or its ingredients

Are There Any Age Restrictions?

Apixaban is generally not recommended for use in children. It is primarily used in adults, especially the elderly, but with caution due to the higher risk of bleeding.

Alcohol or Food Interactions

• Alcohol: Increases the risk of stomach bleeding. Limit or avoid.
• Food: No specific restrictions, but maintain a consistent diet. Unlike warfarin, apixaban is not affected by vitamin K-rich foods (like spinach).

Allergy Warning

• Chest pain or tightness
• Swelling of the face
• Breathing problem
• Dizziness

How to take Apixaban?

Apixaban comes in the form of a tablet. Apixaban medication'should usually be taken with or without food twice a day. When Apixaban is taken for prevention of DVT and PE after hip or Knee replacement surgery the first dosage should be taken in 12 to 24 hours of surgery. Apixaban is taken for 35 days after hip replacement surgery and for 12 days after knee replacement surgery. Try to take Apixaban every day at the same time to avoid any confusion.

If you are not able to swallow the tablet you can crush and mix it with water or juice.

Possible Interactions with Other Medications

Apixaban may interact with several drugs, supplements, and herbal products, increasing the risk of bleeding or affecting how the medicine works. Always inform your doctor about all medications you are taking.

Interactions with Other Medications

• Blood thinners (e.g., warfarin, heparin, aspirin, clopidogrel): Increase the risk of severe bleeding.
• NSAIDs (e.g., ibuprofen, naproxen): It can irritate the stomach and enhance bleeding risk when used with Apixaban.
• Certain antidepressants (SSRIs/SNRIs, like fluoxetine, sertraline): May slightly increase bleeding risk when taken with Apixaban.
• Antifungal drugs (e.g., ketoconazole, itraconazole): Can increase apixaban levels in the blood, leading to more side effects.
• Anti-seizure drugs (e.g., phenytoin, carbamazepine): May lower apixaban's effectiveness by speeding up its breakdown.
• HIV medications (e.g., ritonavir): Can alter Apixaban levels in the blood.

How Should Apixaban Be Stored?

Recommended Storage Temperature for Apixaban

Apixaban should be stored at a controlled room temperature of 20°C to 25°C (68°F to 77°F). Short-term exposure between 15°C and 30°C (59°F to 86°F) is generally acceptable.

What Happens If Apixaban Is Not Stored Properly?

If Apixaban is exposed to extreme heat, cold, moisture, or sunlight, it may lose its effectiveness or stability, which can reduce its ability to prevent blood clots safely.

Storage Tips:

• Keep in a dry place, away from bathrooms or damp areas.
• Do not freeze.
• Keep in the original container with the lid tightly closed.
• Store away from direct sunlight and heat sources.

Always keep Apixaban out of reach of children and dispose of expired or damaged tablets properly.

Apixaban vs Warfarin

References