What is Apixaban ?
Apixaban is an anticoagulant (blood thinner) prescribed to reduce the risk of stroke and blood clots in those with atrial fibrillation (irregular heartbeat). It is also used to treat and reduce the risk of deep vein thrombosis (blood clots) or pulmonary embolism (blockage of the artery in the lung).
Uses of Apixaban
Apixaban is used to:
- Reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation patients with one or more risk factors
- Treat deep venous thrombosis and pulmonary embolism and reduce the risk of recurrence
| Brand Name | Apixaban |
|---|---|
| Type | |
| Weight | |
| Generic | Apixaban |
| Manufacturer | |
| Available in | English বাংলা |
Mechanism of Action
Apixaban works by inhibiting the bodies ability to clot by blocking the activity of the clotting protein thrombin. This reduces the risk of a stroke and systemic embolism in atrial fibrillation patients. It also prevents the formation of new clots and reduces the risk of recurrence of deep venous thrombosis or pulmonary embolism.
How long does it take to work?
Apixaban starts to work within 15 minutes of ingestion, and its effects can be felt up to 12 hours later. It is recommended to take Apixaban twice daily for maximum effect.
Absorption
Apixaban is rapidly and almost completely absorbed from the gastrointestinal tract, with peak concentrations in the blood occurring at 1.5–3 hours after oral administration.
Route of Elimination
Apixaban is primarily eliminated by the kidneys, with an estimated 75% of drug excretion occurring in the urine and 25% in the feces.
Dosage and Administration
The recommended initial dose of Apixaban for the treatment of non-valvular atrial fibrillation is 5 mg taken orally, twice daily. The dose can be increased up to 10 mg twice daily based on the patient's needs. The recommended dose for the treatment of deep venous thrombosis and pulmonary embolism is 10 mg taken orally, twice daily.
Precaution
Apixaban should be used with caution in patients with renal impairment or a known history of bleeding issues. It is also important to inform your doctor about any medications you are currently taking or any allergies you may have.
Interactions
It is important to tell your healthcare professional about all medications you are taking, including herbal supplements, over-the-counter medicines, vitamins, and prescription drugs. Apixaban may interact with certain drugs and increase the risk of bleeding.
Disease Interactions
Apixaban may interact with certain diseases or health conditions. Before starting Apixaban , make sure to inform your healthcare professional if you have any of the following diseases or conditions: kidney disease, liver disease, hemorrhagic disorder, bleeding diathesis, any history of stroke or brain hemorrhage, pre-existing active ulcerative gastrointestinal bleeding, or if you are pregnant or planning a pregnancy.
Drug Interaction
Tell your doctor and pharmacist of all prescription and nonprescription medications that you're taking, including herbal supplements. There are several drugs that can increase the risk of bleeding when taken with Apixaban (e.g., aspirin, nonsteroidal anti-inflammatory drugs). Make sure to inform your healthcare professional of all medication that you are taking.
Food Interactions
It is recommended to not take Apixaban with food or grapefruit juice. Alcohol should also be avoided.
Pregnancy Use
Apixaban should not be used during pregnancy. It is important to talk to your doctor before taking this drug if you are pregnant or planning to become pregnant.
Lactation Use
Apixaban is excreted in breast milk and should not be taken while nursing.
Acute Overdose
If you think you have overdosed on Apixaban , seek medical attention as soon as possible. Symptoms of an overdose may include severe bleeding, weakness, dizziness, confusion, and an abnormally slow heart rate.
Contraindication
Apixaban should not be used in patients who have a known hypersensitivity to it, a history of bleeding episodes, or in patients with severe hepatic or renal impairment.
Use Direction
Apixaban should be taken by mouth as directed by the healthcare professional. Do not take more than the recommended dosage. Take the tablets with a full glass of water and swallow them whole. Do not break, chew, or crush the tablets.
Storage Condition
Keep Apixaban in a tightly sealed container at room temperature. Store tablets away from heat, moisture, and direct light.
Volume of Distribution
The approximate volume of distribution for Apixaban is 17 litres.
Half Life
The half-life of Apixaban is approximately 10 hours.
Clearance
The elimination clearance of Apixaban is approximately 50 ml/min.
See in details version Apixaban also Apixaban in bangla
Some Frequently Asked Questions About Apixaban
1. What is apixaban?
Apixaban is an oral anticoagulant (blood thinner) that helps prevent and treat blood clots by inhibiting Factor Xa, a key component in the blood clotting process.
2. What is apixaban used for?
It is used to:
3. How does apixaban work?
It blocks Factor Xa, an enzyme in the clotting cascade, reducing the ability of blood to form clots.
4. Is apixaban a prescription drug?
Yes, apixaban is available only with a doctor’s prescription.
5. Who can take apixaban?
It is prescribed for adults at risk of blood clots, but not for those with active bleeding, certain liver conditions, or artificial heart valves.
6. How is apixaban taken?
It is taken orally as a tablet, with or without food, usually twice daily.
7. What is the typical dosage of apixaban?
8. How long does apixaban take to work?
It starts working within 3-4 hours, reaching peak effect in about 3-4 hours after a dose.
9. Can apixaban be taken long-term?
Yes, it may be prescribed long-term for conditions like atrial fibrillation or recurrent DVT, as directed by a doctor.
10. Does apixaban require blood monitoring?
No, unlike warfarin, apixaban does not require routine blood tests to monitor clotting levels.
11. What are the common side effects of apixaban?
Common side effects include:
12. Can apixaban cause serious bleeding?
Yes, it increases bleeding risk, including potentially life-threatening internal bleeding. Seek immediate help if you notice unusual bleeding.
13. Is there an antidote for apixaban?
Yes, andexanet alfa is an antidote used in emergencies to reverse apixaban’s effects if severe bleeding occurs.
14. Can apixaban be taken with food?
Yes, it can be taken with or without food, as food does not affect its absorption.
15. What happens if I miss a dose of apixaban?
Take it as soon as you remember if it’s within 6 hours of the scheduled time; otherwise, skip it and resume the next dose. Don’t double up.
16. Can I overdose on apixaban?
Yes, an overdose can increase bleeding risk. Seek emergency medical attention if too much is taken.
17. Is apixaban safe during pregnancy?
No, it is not recommended during pregnancy due to potential harm to the fetus. Consult a doctor for alternatives.
18. Can breastfeeding mothers take apixaban?
It’s not advised, as it may pass into breast milk. Discuss with your doctor.
19. Does apixaban interact with other medications?
Yes, it can interact with:
20. Can I drink alcohol while taking apixaban?
Moderate alcohol is usually fine, but excessive drinking increases bleeding risk. Consult your doctor.
21. Is apixaban safe for people with kidney disease?
It can be used with caution, but the dose may be adjusted based on kidney function. It’s not recommended in severe kidney failure.
22. Can apixaban be used in liver disease?
It should be avoided in severe liver disease due to increased bleeding risk.
23. How should apixaban be stored?
Store at room temperature, away from moisture and heat, in its original container.
24. Does apixaban expire?
Yes, check the expiration date on the package. Expired apixaban may lose effectiveness.
25. Can apixaban cause hair loss?
Hair loss is not a common side effect, but consult your doctor if it occurs.
26. Is apixaban the same as warfarin?
No, apixaban is a direct oral anticoagulant (DOAC) with a different mechanism and fewer dietary restrictions than warfarin.
27. Can I take apixaban before surgery?
You may need to stop it 24-48 hours before surgery to reduce bleeding risk. Follow your doctor’s instructions.
28. Does apixaban affect blood pressure?
No, it does not directly affect blood pressure.
29. Can apixaban cause stomach pain?
It’s uncommon, but gastrointestinal upset or bleeding can occur. Report severe pain to your doctor.
30. Is apixaban gluten-free?
Yes, apixaban tablets are typically gluten-free, but check with the manufacturer for confirmation.
31. Can apixaban be crushed?
Yes, it can be crushed and mixed with water or applesauce for those who can’t swallow tablets, per doctor’s advice.
32. What if I’m allergic to apixaban?
Allergic reactions are rare, but stop use and seek help if you experience rash, swelling, or breathing issues.
33. Can apixaban cause dizziness?
Dizziness isn’t common but could occur due to bleeding or low blood pressure. Consult your doctor if persistent.
34. Does apixaban affect the liver?
It’s metabolized by the liver but rarely causes liver damage. Monitor for signs like yellowing skin.
35. Can apixaban be used for heart attack prevention?
It’s not typically used for heart attack prevention but may be part of treatment plans in specific cases.
36. Is apixaban safe for elderly patients?
Yes, but the dose may be lowered (e.g., 2.5 mg) based on age, weight, or kidney function.
37. Can apixaban cause weight gain?
No, weight gain is not a known side effect of apixaban.
38. Does apixaban need refrigeration?
No, store it at room temperature.
39. Can apixaban treat existing blood clots?
Yes, it’s used to treat DVT and PE by preventing clots from growing and reducing recurrence risk.
40. What’s the difference between apixaban and aspirin?
Apixaban is a stronger anticoagulant targeting Factor Xa, while aspirin is an antiplatelet drug with milder effects.
41. Can apixaban cause fatigue?
Fatigue isn’t a direct side effect but could result from anemia due to bleeding.
42. Is apixaban available as a generic?
Yes, generic versions are available in some regions as of 2025, though brand-name Eliquis is still common.
43. Can apixaban be taken at night?
Yes, it can be taken at any time, as long as doses are about 12 hours apart.
44. Does apixaban affect cholesterol?
No, it does not impact cholesterol levels.
45. Can apixaban be used with stents?
It may be used with stents in specific cases (e.g., atrial fibrillation), but this requires careful medical oversight.
46. What should I do if I notice blood in my urine?
Stop apixaban and contact your doctor immediately, as this could indicate bleeding.
47. Can apixaban cause joint pain?
Joint pain isn’t a typical side effect, but bleeding into joints (rare) could cause discomfort.
48. Does apixaban interact with vitamins?
It has minimal interaction with vitamins, but high doses of vitamin K (found in supplements) may slightly counteract its effects.
49. Can apixaban be stopped abruptly?
Do not stop without a doctor’s advice, as this increases clot risk.
Maj. Gen. Prof. Dr. S. M. Motahar Hossain
Medicine & Gastro Liver Diseases Specialist
Medicine Specialist Doctor in Dhaka
Prof. Dr. Shahin Rahman Chowdhury
Gynecology, Infertility Specialist & Laparoscopic Surgeon
Gynecologist in Dhaka