Apixaban

NHS information about apixaban, including what it's used for, who can take it, how to take it and side effects.

What apixaban is for

Apixaban is a medicine called an anticoagulant. It helps to prevent blood clots forming. Some people call these blood thinners.

It's used to treat or prevent conditions such as:

• a blood clot in a vein (usually in the leg) called deep vein thrombosis (DVT)
• a blood clot in your lungs called a pulmonary embolism

It's also used to prevent:

• blood clots and stroke in people with a heart rhythm problem called atrial fibrillation
• blood clots forming in people who've had knee replacement or hip replacement surgery

How to take apixaban

Apixaban comes as tablets you swallow.

How much to take and for how long depends on why you're taking it.

It's usually taken twice a day.

When taking apixaban:

• try to take it at the same time each day – if you take it twice a day, this could be once in the morning and once in the evening
• you can take it with or without food

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or you have any problems taking it.

If you have problems swallowing tablets, you can crush the tablets and mix them with water, apple juice or apple purée. Follow the instructions that come with your medicine on how to do this.

If you miss a dose of apixaban

If you forget to take a dose of apixaban, take it as soon as you remember. Take your next dose at the usual time and then continue as normal.

Speak to your doctor or a pharmacist if you've missed a dose and are not sure what to do.

If you take too much apixaban

Taking an extra dose of apixaban can be dangerous.

Get help from NHS 111 if:

Side effects of apixaban

Like all medicines, apixaban can cause side effects, but not everyone gets them.

One of the most common side effects of taking apixaban is bleeding more than usual. This might include:

• bleeding for longer than usual if you cut yourself
• nosebleeds
• bleeding from your gums when you brush your teeth
• bruises that come up more easily and take longer to fade than usual
• periods that are heavier and last longer than usual

Other side effects could include:

• a problem with your blood cells (anaemia), which can make you feel tired and your skin paler than usual
• feeling sick (nausea)
• a rash

Apixaban should not affect your ability to drive, ride a bike or use machinery.

Important

You'll be given an anticoagulant alert card because apixaban may put you at risk of bleeding. Always carry this with you. Show it to your doctor or dentist before you have any medical or dental procedures.

More about side effects

These are not all the side effects of apixaban.

For a full list, see the leaflet that comes with your medicine or search for your medicine on the electronic medicines compendium website.

You can report any side effects you get on the Yellow Card website

Who can and cannot take apixaban

Most adults can take apixaban. Apixaban may be prescribed for children weighing more than 35kg.

Apixaban is not suitable for some people. For example, it may not be suitable if:

• you've had an allergic reaction or serious side effect from apixaban or another anticoagulant
• you have injuries that are bleeding a lot
• you have a stomach or bowel ulcer
• you have liver or kidney disease
• you've recently had a bleed in your brain
• you're pregnant or breastfeeding

Before taking apixaban, tell your doctor or a pharmacist if you have any medical conditions.

Breastfeeding and apixaban

Tell your doctor if you're breastfeeding. Apixaban should not be used while breastfeeding.

Pregnancy and apixaban

Tell your doctor if you're pregnant or planning to get pregnant. Apixaban is not used during pregnancy.

Taking apixaban with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with apixaban.

These include:

• other medicines that prevent blood clots (anticoagulants), such as warfarin
• medicines for fungal infections (antifungal medicines)
• medicines for high blood pressure or heart problems
• antidepressant medicines, such as SSRIs
• painkillers or anti-inflammatories (NSAIDs)
• the herbal remedy for low mood, St John's Wort
• HIV medicines, such as ritonavir

Before taking apixaban, tell your doctor or a pharmacist if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with apixaban

You can eat and drink as normal while taking apixaban.

Find out more about your medicine

To find out more about your medicine, you can:

• check the leaflet that comes with it
• search for your medicine leaflet on the electronic medicines compendium website
• speak to a pharmacist or doctor – if you recently started taking the medicine, a pharmacist may be able to offer advice and support as part of the New Medicines Service