Eliquis  [ apixaban ]

What is Eliquis?

Eliquis blocks the activity of certain clotting substances in the blood.

Eliquis is used to lower the risk of stroke or a blood clot in people with a heart rhythm disorder called atrial fibrillation.

Eliquis reduces the risk of forming a blood clot in the legs and lungs of people who have just had hip or knee replacement surgery.

Eliquis treats blood clots in the veins of your legs (DVT – deep vein thrombosis) or lungs (pulmonary embolism), and reduce the risk of them occurring again.

Warnings

Eliquis increases your risk of severe or fatal bleeding, especially if you take certain medicines at the same time (including some over-the-counter medicines). It is very important to tell your doctor about all medicines you have recently used.

Call your doctor at once if you have signs of bleeding such as: swelling, pain, feeling very weak or dizzy, bleeding gums, nosebleeds, heavy menstrual periods or abnormal vaginal bleeding, blood in your urine, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds, or any bleeding that will not stop.

Eliquis should be stopped 24-48 hours prior to any surgery, invasive procedure, or dental work. Tell your surgeon if you are taking Eliquis.

Eliquis can cause a very serious blood clot around your spinal cord that can lead to long-term or permanent paralysis. This type of blood clot can occur during a spinal tap or spinal anesthesia (epidural), especially if you have a genetic spinal defect, if you use a spinal catheter, if you’ve had spinal surgery or repeated spinal taps, or if you use

drugs that can affect blood clotting.

Eliquis can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural), especially if you have a genetic spinal defect, if you have a spinal catheter in place, if you have a history of spinal surgery or repeated spinal taps, or if you are also using other drugs that can affect blood clotting. This type of blood clot can lead to long-term or permanent paralysis.

Get emergency medical help if you have symptoms of a spinal cord blood clot such as back pain, numbness or muscle weakness in your lower body, or loss of bladder or bowel control.

Do not stop taking Eliquis unless your doctor tells you to. Stopping suddenly can increase your risk of blood clot or stroke.

Before taking this medicine

You should not take Eliquis if you are allergic to apixaban, or if you have active bleeding from a surgery, injury, or other cause.

Eliquis may cause you to bleed more easily, especially if you have a bleeding disorder that is inherited or caused by disease.

Tell your doctor if you have an artificial heart valve, or if you have ever had:

bleeding problems;

antiphospholipid syndrome, especially if you have a triple positive antibody test; or

liver or kidney disease.

Eliquis can cause a very serious blood clot around your spinal cord if you undergo a spinal tap or receive spinal anesthesia (epidural). This type of blood clot could cause long-term paralysis, and may be more likely to occur if:

you have a spinal catheter in place or if a catheter has been recently removed;

you have a history of spinal surgery or repeated spinal taps;

you have recently had a spinal tap or epidural anesthesia;

you take or other NSAIDs (nonsteroidal anti-inflammatory drugs) – ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac, indomethacin, meloxicam, and others; or

you are using other medicines to treat or prevent blood clots.

Taking Eliquis may increase the risk of bleeding while you are pregnant or during your delivery. Tell your doctor if you are pregnant or plan to become pregnant.

Do not breastfeed.

Eliquis pregnancy and breastfeeding warnings (more detail)

How should I take Eliquis?

Take Eliquis exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

You may take Eliquis with or without food.

If you cannot swallow a tablet whole, crush it and mix with water, apple juice, or applesauce. Swallow the mixture right away without chewing.

A crushed tablet mixture may also be given through a nasogastric (NG) feeding tube. Read and carefully follow any Instructions for Use provided with your medicine.

Eliquis can make it easier for you to bleed, even from a minor injury. Seek medical attention if you have bleeding that will not stop.

Tell your doctor if you have a planned surgery or dental work. You may need to stop taking Eliquis for a short time.

Do not stop taking Eliquis unless your doctor tells you to.

If you stop taking Eliquis for any reason, your doctor may prescribe another medicine to prevent blood clots.

Store at room temperature away from moisture and heat.

Dosing information

Usual Adult of Eliquis Dose for Deep Vein Thrombosis — Prophylaxis:

DEEP VEIN THROMBOSIS (DVT) PROPHYLAXIS FOLLOWING HIP OR KNEE REPLACEMENT SURGERY:
2.5 mg orally twice a day

Duration of therapy:
-Hip replacement: 35 days
-Knee replacement: 12 days

Comments: The initial dose should be taken 12 to 24 hours after surgery.

Use: Prophylaxis of DVT, which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.

RECURRENT DVT AND PE RISK REDUCTION:
2.5 mg orally twice a day.

Usual Adult Dose of Eliquis for Deep Vein Thrombosis Prophylaxis after Hip Replacement Surgery:

DEEP VEIN THROMBOSIS (DVT) PROPHYLAXIS FOLLOWING HIP OR KNEE REPLACEMENT SURGERY:
2.5 mg orally twice a day

Duration of therapy:
-Hip replacement: 35 days
-Knee replacement: 12 days

Comments: The initial dose should be taken 12 to 24 hours after surgery.

Use: Prophylaxis of DVT, which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.

RECURRENT DVT AND PE RISK REDUCTION:
2.5 mg orally twice a day.

Adult Dose for of Eliquis Deep Vein Thrombosis Prophylaxis after Knee Replacement Surgery:

DEEP VEIN THROMBOSIS (DVT) PROPHYLAXIS FOLLOWING HIP OR KNEE REPLACEMENT SURGERY:
2.5 mg orally twice a day

Duration of therapy:
-Hip replacement: 35 days
-Knee replacement: 12 days

Comments: The initial dose should be taken 12 to 24 hours after surgery.

Use: Prophylaxis of DVT, which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery.

RECURRENT DVT AND PE RISK REDUCTION:
2.5 mg orally twice a day.

Usual Adult Dose of Eliquis for Prevention of Thromboembolism in Atrial Fibrillation:

5 mg orally 2 times a day

Use: Reduction of risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.

Usual Adult Dose of Eliquis for Thromboembolic Stroke Prophylaxis:

5 mg orally 2 times a day

Use: Reduction of risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.

Adult Dose for Deep Vein Thrombosis:

Initial dose: 10 mg orally 2 times a day for 7 days
Maintenance dose: 5 mg orally 2 times a day

Use: Treatment of deep vein thrombosis and pulmonary embolism.

Usual Adult Dose for Pulmonary Embolism:

Initial dose: 10 mg orally 2 times a day for 7 days
Maintenance dose: 5 mg orally 2 times a day

Use: Treatment of deep vein thrombosis and pulmonary embolism.

Detailed Eliquis dosage information

What happens if I miss a dose?

Take the missed dose on the same day you remember it. Take your next dose at the regular time and stay on your twice-daily schedule. Do not take two doses at one time.

Get your prescription refilled before you run out of Eliquis completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Eliquis?

Avoid activities that may increase your risk of bleeding or injury. Use extra care while shaving or brushing your teeth.

Eliquis side effects

Get emergency medical help if you have signs of an allergic reaction to Eliquis: hives; chest pain, wheezing, difficult breathing; feeling light-headed; swelling of your face, lips, tongue, or throat.

Also seek emergency medical attention if you have symptoms of a spinal blood clot such as tingling, numbness, or muscle weakness especially in your legs and feet.

Call your doctor at once if you have:

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), bleeding from wounds or needle injections, any bleeding that will not stop;

heavy menstrual bleeding;

headache, dizziness, weakness, feeling like you might pass out;

urine that looks red, pink, or brown; or

black or bloody stools, coughing up blood or vomit that looks like coffee grounds.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Eliquis side effects (more detail)

What other drugs will affect Eliquis?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many other drugs (including some over-the-counter medicines) can increase your risk of bleeding or blood clots. Tell your doctor about all medicines you have recently used, especially:

any other medicines to treat or prevent blood clots;

a blood thinner such as heparin or warfarin (Coumadin, Jantoven);

an antidepressant; or

aspirin or other NSAID (nonsteroidal anti-inflammatory drug) used long term.

This list is not complete and many other drugs may interact with apixaban. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.