WARNING

Apixaban, like other anticoagulants, carries several risks due to its blood-thinning effects. Understanding these risks can help you manage them more effectively. Here’s a detailed look at the potential risks:

• Major Bleeding: Apixaban increases the risk of severe bleeding events, such as gastrointestinal bleeding (e.g., vomiting blood or having black stools), bleeding in the brain (causing headaches, dizziness, or confusion), or bleeding in other critical areas. This is the most significant risk and requires immediate medical attention.
• Minor Bleeding: Common but less severe, including nosebleeds, bleeding gums, or easy bruising. While generally not life-threatening, these should be monitored.
• Risk of Stroke: While Apixaban is used to reduce the risk of stroke in patients with atrial fibrillation, there is still a risk of bleeding-related strokes. Symptoms of a hemorrhagic stroke include sudden severe headache, sudden confusion, difficulty speaking or understanding speech, or sudden vision changes.
• Risk: Apixaban can increase the risk of bleeding in the digestive tract, which may manifest as blood in the stool or vomit. This risk is higher in individuals with a history of gastrointestinal issues or ulcers.
• Kidney Issues: Impaired kidney function can lead to increased levels of Apixaban in the blood, raising bleeding risk. Regular monitoring may be necessary.
• Liver Issues: Liver impairment can affect how Apixaban is processed in the body, potentially leading to increased bleeding risk. Patients with liver problems should be closely monitored.
• Drug Interactions: Apixaban can interact with other medications, including over-the-counter drugs and herbal supplements. These interactions can either increase bleeding risk or reduce Apixaban’s effectiveness. Always inform your healthcare provider of all the medications you are taking.
• Pregnancy: Apixaban is generally not recommended during pregnancy due to potential risks to the fetus. Alternative treatments may be considered.
• Breastfeeding: Apixaban is not recommended during breastfeeding due to potential risks to the infant. Discuss alternatives with your healthcare provider.
• Bleeding Risk: If you are undergoing surgery or dental work, you may need to stop Apixaban temporarily to reduce bleeding risks. Coordinate with your healthcare provider to manage this appropriately.
• Bleeding Disorders: Individuals with a history of bleeding disorders or conditions that affect blood clotting should be cautious. Apixaban can exacerbate these conditions.
• High Blood Pressure: Uncontrolled high blood pressure can increase bleeding risks. Managing blood pressure is important while on Apixaban.
• Overdose: In case of an overdose, the risk of severe bleeding is heightened. Immediate medical intervention is required to manage potential bleeding complications.

Always follow your healthcare provider’s instructions and contact them if you experience any concerning symptoms or have questions about the risks associated with Apixaban.

Why is this medication prescribed?

Apixaban is prescribed primarily to prevent and treat blood clots. Here are some of its common uses:

• Prevention of Stroke and Blood Clots: It’s used to reduce the risk of stroke and blood clots in people with nonvalvular atrial fibrillation (AFib), a type of irregular heartbeat.
• Treatment of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): It helps in treating DVT and PE and in preventing these conditions from recurring.
• Prevention of Blood Clots After Surgery: Apixaban may be prescribed to prevent blood clots in patients who have undergone certain types of surgeries, such as hip or knee replacement surgery.
• Treatment of Blood Clots: It is used to treat existing blood clots and to reduce the risk of developing new ones.

Apixaban is an oral anticoagulant, which means it helps to prevent the formation of harmful blood clots by inhibiting certain factors in the blood clotting process.

How should this medicine be used?

Apixaban should be used exactly as prescribed by your healthcare provider. Here are some general guidelines for its use:

• Dosage: Follow the dosage instructions given by your doctor. The typical dose for most conditions is taken twice daily.
• Administration: Take Apixaban by mouth, with or without food. It is usually in the form of a tablet, which should be swallowed whole. Do not crush, chew, or break the tablets.
• Consistency: Take it at the same times each day to help remember to take it consistently.
• Missed Dose: If you miss a dose, take it as soon as you remember on the same day. If it’s almost time for your next dose, skip the missed dose; do not double up to make up for a missed dose.
• Interactions: Be aware of potential drug interactions. Inform your healthcare provider about all other medications, including over-the-counter drugs, supplements, and herbal products.
• Regular Monitoring: Although Apixaban generally doesn’t require routine blood monitoring like some other blood thinners, your doctor may periodically check your health to ensure the medication is working properly.
• Avoid Certain Activities: Apixaban increases bleeding risk, so avoid activities that might lead to injury or bleeding. Inform your healthcare provider immediately if you experience unusual bleeding or bruising.

Always follow your healthcare provider’s specific instructions and consult them if you have any questions or concerns about taking Apixaban.

Other uses for this medicine

In addition to its primary uses for preventing stroke in atrial fibrillation and treating blood clots, Apixaban is also prescribed for:

• Post-Surgical Prevention: Preventing blood clots in patients undergoing certain surgeries, like hip or knee replacements.
• Prevention of Recurrent Blood Clots: Reducing the risk of DVT or PE from recurring after initial treatment.

What special precautions should I follow?

Special Precautions for Apixaban:

• Bleeding Risk: Apixaban increases the risk of bleeding, which can be serious. Be cautious to avoid injuries and contact sports. Report any unusual bleeding or bruising to your healthcare provider immediately.
• Kidney and Liver Function: If you have kidney or liver problems, your doctor may need to adjust your dosage or monitor you more closely. Inform your doctor if you have a history of kidney or liver disease.
• Other Medications: Inform your healthcare provider about all other medications you are taking, including over-the-counter drugs, supplements, and herbal products. Some medications can interact with Apixaban and increase the risk of bleeding or affect how well Apixaban works.
• Pregnancy and Breastfeeding: Apixaban is not recommended during pregnancy unless clearly needed, as it may harm the unborn baby. It’s also not advised during breastfeeding. Discuss with your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
• Surgery or Dental Work: If you need surgery or dental work, tell your healthcare provider and dentist that you are taking Apixaban. You may need to stop taking it temporarily to reduce the risk of bleeding.
• Alcohol Consumption: Limit alcohol intake as it can increase the risk of bleeding and affect how Apixaban works.
• Medical Conditions: Inform your doctor if you have any medical conditions that might increase your risk of bleeding, such as bleeding disorders, high blood pressure, or gastrointestinal issues.

Always follow the specific advice given by your healthcare provider regarding Apixaban and consult them if you have any concerns or questions about its use.

What special dietary instructions should I follow?

Unlike some other anticoagulants, Apixaban does not require dietary restrictions related to vitamin K intake (such as limiting leafy greens). However:

• Consistent Diet: While no specific dietary restrictions are necessary, try to maintain a consistent diet to avoid any unexpected interactions or fluctuations in your condition.
• Alcohol Intake: Limit alcohol consumption, as excessive alcohol can increase bleeding risk and impact the medication’s effectiveness.

What should I do if I forget a dose?

• Take as Soon as Possible: If you remember within 12 hours of your missed dose, take it as soon as you can.
• Skip if Close to Next Dose: If it’s almost time for your next dose, skip the missed dose; do not double up to make up for a missed dose.
• Resume Regular Schedule: Continue taking your next dose at the regular scheduled time.
• Consult Your Doctor: If you miss doses frequently or have concerns, contact your healthcare provider for advice on how to manage missed doses.

What side effects can this medication cause?

Apixaban can cause a range of side effects, though not everyone experiences them. Common and serious side effects include:

Common Side Effects:

• Bleeding: Minor bleeding, such as nosebleeds, bleeding gums, or easy bruising.
• Gastrointestinal Issues: Nausea or abdominal pain.
• Fatigue: Feeling unusually tired or weak.

Serious Side Effects:

• Severe Bleeding: This includes bleeding in the brain (headaches, confusion), stomach (vomiting blood, black stools), or other severe bleeding. This is a serious condition and requires immediate medical attention.
• Allergic Reactions: Symptoms like rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing.
• Liver Issues: Symptoms such as yellowing of the skin or eyes (jaundice), dark urine, or unusual tiredness.
• Kidney Problems: Symptoms like changes in urine output or swelling in the legs and ankles.
• Anemia: Symptoms like feeling faint, pale skin, or shortness of breath.
• Headaches: Persistent or severe headaches.

If you experience any of these serious side effects, seek medical attention immediately. For common side effects, consult your healthcare provider if they persist or become bothersome.

What should I know about storage and disposal of this medication?

Storage and Disposal of Apixaban:

Storage:

• Store Apixaban at room temperature, typically between 68°F and 77°F (20°C and 25°C).
• Keep the medication in a dry place, away from moisture and heat.
• Store it in the original container with the lid tightly closed to protect it from light and moisture.
• Keep the medication out of reach of children and pets.

Disposal:

• Do not dispose of Apixaban in household trash or flush it down the toilet. Instead, use a drug take-back program or follow local disposal guidelines.
• Many communities have drug take-back programs or events for safe disposal of medications. Check with your pharmacist or local waste disposal authority.
• If no take-back programs are available, consult your pharmacist for advice on safe disposal options.

In case of emergency/overdose

• Seek Immediate Medical Help: If you suspect an overdose or experience severe symptoms, such as excessive bleeding, seek emergency medical attention right away.
• Call Poison Control: In the event of an overdose, contact your local poison control center or emergency services.
• Severe Bleeding: Uncontrolled bleeding or bruising, blood in urine or stools, or bleeding from the gums.
• Dizziness or Fainting: Feeling extremely weak or faint.

What other information should I know?

• Regular Check-Ups: While routine blood tests are not typically required with Apixaban, your healthcare provider may monitor your condition and overall health regularly.
• Adherence: It’s important to take Apixaban exactly as prescribed. Missing doses or taking more than prescribed can impact its effectiveness and increase the risk of bleeding.
• Medical History: Keep your healthcare provider informed about your complete medical history and any other medications you are taking, as these can affect how Apixaban works.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Apixaban with your healthcare provider.
• Emergency Medical ID: Consider wearing a medical ID bracelet or necklace that identifies you as a user of Apixaban, especially in case of emergencies.

Always follow your healthcare provider’s instructions and consult them if you have any questions or concerns about Apixaban.