ELIQUIS (Apixaban)

What is this medication?

ELIQUIS (Apixaban)
Direct oral anticoagulant; Factor Xa Inhibitor

ELIQUIS (Apixaban) is officially indicated for atrial fibrillation, venous thromboembolism, deep vein thrombosis, or pulmonary embolism.  It is also prescribed off-label for heparin induced thrombocytopenia.

ALERT: WARNING
Premature discontinuation of any oral anticoagulant, including apixaban, increases the risk of thrombotic events. An increased rate of stroke was observed following discontinuation of apixaban.  If anticoagulation with apixaban must be discontinued for a reason other than pathological bleeding or completion of a course of therapy, consider coverage with another anticoagulant.

How does this medication work? 

ELIQUIS (Apixaban) reversibly inhibits factor Xa which is responsible for catalyzing the conversion of prothrombin to thrombin as part of both the intrinsic and extrinsic coagulation pathways.  Thrombin activates platelets and catalyzes the conversion of fibrinogen to fibrin.  Blocking factor Xa thereby results in inhibited platelet activation and fibrin clot formation.

How should I take this medication? 

Oral: Take 5mg twice daily.

How to Take: Take with or without food.

Note: In patients with at least 2 of the following characteristics: age 80 years, body weight 60 kg, or serum creatinine 1.5 mg/dL, the recommended dose is 2.5 mg orally twice daily.

What should I watch for while using this medication? 

Before starting ELIQUIS (Apixaban), make sure your physician is aware of any allergies or medications you currently take.  Do not stop this medication suddenly or without involvement of your physician.  Prematurely stopping this medication can cause increased risk of a thrombotic event such as stroke so generally if changing medications, a bridging schedule is required.  Confirm with your physician if you are wanting to use any NSAIDs such as ibuprofen, ASA, or naproxen.  Do not self-select over the counter items such as these without asking a medical professional due to risk of ulceration and a severe hemorrhage. It may take longer than usual for bleeding to stop, and you may bruise or bleed or easily when treated with Apixaban.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

The main side effects are bruising and hemorrhage (bleeding) both minor and major.  Patient should monitor for weakness, dizziness, unexplained edema, black tarlike stool, what appears to be coffee grounds in vomit, major unexplained bruising, minor cuts that do not stop bleeding, blood when brushing teeth etc.  These are signs of over anticoagulation or an internal bleed in which case immediate medical attention is required.

Note this is not a complete list of side effects for ELIQUIS (Apixaban), only common ones.