Eliquis (Apixaban)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Eliquis Used For?
Eliquis contains apixaban and belongs to a group of medicines called antithrombotic agents. It works by blocking a blood clot forming substance called Factor Xa.
Primary Uses
Eliquis is used to prevent blood clots in your veins after hip or knee replacement surgery, treat blood clots in deep veins (Deep Vein Thrombosis) and lungs (Pulmonary Embolism) and prevent them from recurring, and prevent stroke and blood clots in atrial fibrillation (abnormal heart rhythm).
How It Works
Eliquis works by inhibiting Factor Xa, a substance that helps form blood clots. With atrial fibrillation, part of the heart doesn’t beat properly, which can lead to blood clots forming and increase stroke risk.
How to Take Eliquis
Your doctor will tell you exactly how many tablets to take each day. Swallow the tablets whole with a full glass of water, and take them at about the same time each day for best results.
Dosage Instructions
For hip or knee replacement surgery: one 2.5 mg tablet twice daily, usually starting 12-24 hours after surgery. For treating blood clots: two 5 mg tablets twice daily for 7 days, then one 5 mg tablet twice daily. For preventing recurring blood clots: one 2.5 mg tablet twice daily. For atrial fibrillation: normally one 5 mg tablet twice daily, or one 2.5 mg tablet twice daily if you are 80+ years old, weigh 60 kg or less, or have reduced kidney function.
What If You Miss a Dose?
If you miss a dose, take your next tablet as soon as you remember, then continue taking tablets as normal (twice daily). If it’s almost time for your next dose, skip the missed dose and take your next dose when scheduled.
Important: Never take a double dose to make up for a missed dose. If you can’t swallow tablets whole, ask your doctor about crushing instructions.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Tiredness, weakness, paleness, dizziness, light-headedness, headache (may be due to low iron)
- Bleeding from any part of your body, even minor bleeding
- Bruising
- Nausea, vomiting
- Diarrhea or constipation
- Fever
- Sore nasal passages and throat
- Frequent urination or pain while urinating
- Coughing
Seek immediate medical attention if you experience:
- Bleeding from nose, dark brown urine or blood in urine, coughing up blood, black vomit, black stools or blood in stools, excessive or prolonged bleeding
- Allergic reactions: shortness of breath, wheezing, difficulty breathing, swelling of face/lips/tongue/body parts, rash, itching, hives
- Anticoagulant-related nephropathy: blood in urine, reduced urine output, swelling of legs/ankles/feet, increased clotting time, heavy bleeding
- Stomach swelling, yellowing of skin or whites of eyes (liver problems)
- Oozing from surgical wounds
- Swelling of hands, ankles, or feet due to water retention
Important Warnings
There are several important conditions and situations where Eliquis should not be used or requires special caution.
Who Should Not Take Eliquis
Do not use if you’re allergic to apixaban, have active bleeding or high bleeding risk (like stomach ulcers, recent brain bleeding, cancer with high bleeding risk), liver disease causing bleeding risk, severely reduced kidney function, recent brain/spine/eye surgery, recent brain or spine injury, blood vessel abnormalities that increase bleeding, or are taking certain medications like ketoconazole, ritonavir, or other blood thinners.
Medical Conditions to Discuss
Tell your doctor if you have heart conditions, are 75+ years old, have bacterial endocarditis, history of hemorrhagic stroke, blood disorders affecting clotting, stomach/bowel ulcers, kidney or liver disease, lung condition called bronchiectasis, history of lung bleeding, uncontrolled high blood pressure, prosthetic heart valve, severe rheumatic heart disease, antiphospholipid syndrome, or are having spinal procedures.
Pregnancy and Breastfeeding
Eliquis is not recommended during pregnancy or breastfeeding. The medication may be present in breast milk and poses bleeding risk to the baby. Tell your doctor immediately if you become pregnant while taking Eliquis.
Surgery Warning: Eliquis must be temporarily stopped before surgery. Always tell your surgeon, doctor, or dentist that you’re taking this medication.
Drug Interactions
Some medicines may interfere with Eliquis and affect how it works. You may need different amounts of your medicines or different medicines entirely.
- Fungal infection medicines (ketoconazole, itraconazole, voriconazole, posaconazole)
- HIV/AIDS medicines (ritonavir)
- Rifampin or rifampicin
- Epilepsy medicines (phenytoin, carbamazepine, phenobarbitone)
- St John’s wort
- Depression medicines (sertraline, citalopram, venlafaxine)
- Pain and inflammation medicines including NSAIDs (naproxen, aspirin)
- Other blood clot prevention medicines (enoxaparin, clopidogrel, ticagrelor, prasugrel, heparin, fondaparinux, bivalirudin, rivaroxaban, dabigatran, dipyridamole)
- Quinidine, verapamil, diltiazem, amiodarone
- Clarithromycin antibiotic
Alcohol & Driving
Eliquis is not expected to affect your ability to drive or operate machinery, but use caution and notify your doctor if you notice any changes to your abilities.
Alcohol
No specific alcohol warnings are mentioned in the source material. Consult your doctor about alcohol consumption while taking Eliquis.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Eliquis affects you. This medicine is not expected to affect your driving ability, but use caution when performing these activities.
Storage
Keep tablets in the original pack until it’s time to take them. Store in a cool, dry place away from moisture, heat, or sunlight. Don’t store in the bathroom, near a sink, in the car, or on windowsills. Keep out of reach of children – a locked cupboard at least 1.5 meters above ground is ideal.
Overdose Information
If you think you or anyone else has taken too much Eliquis, seek urgent medical attention immediately. Call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital Emergency Department. Do this even if there are no signs of discomfort. Overdose symptoms may include bleeding that doesn’t stop, and treatment may require surgery, blood transfusions, or other treatments to reverse the medication’s effects.
Frequently Asked Questions
The source doesn’t specify exact timing, but Eliquis is typically started 12-24 hours after hip or knee replacement surgery, suggesting it begins working relatively quickly.
Yes, it doesn’t matter if you take Eliquis before or after food. You can take it with or without meals.
Never stop taking Eliquis suddenly without checking with your doctor first. If you stop suddenly, you may be at increased risk of developing blood clots, which can lead to serious problems like stroke if you have atrial fibrillation.
Treatment duration varies: about 5 weeks for hip replacement, 2 weeks for knee replacement, up to 6 months for treating blood clots, and as long as your doctor tells you for atrial fibrillation. Your doctor will determine the right duration for your condition.
Always tell your surgeon, doctor, or dentist that you’re taking Eliquis. The medication should be temporarily stopped before surgery, and your doctor will tell you when to stop and when to restart after the procedure.
Yes, if you can’t swallow tablets whole, you can crush them using a mortar and pestle, then mix with water, 5% dextrose in water, apple juice, or apple sauce following specific instructions provided by your doctor.
Watch for any signs of bleeding including nosebleeds, blood in urine or stools, coughing up blood, black vomit, excessive bruising, or bleeding that doesn’t stop. Contact your doctor immediately if you experience any of these symptoms.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.