If you are taking apixaban to help prevent strokes or serious blood clots and have atrial fibrillation (a condition in which the heart beats erratically, increasing the risk of clots forming in the body and potentially causing strokes), you are at an increased risk of having a stroke after stopping this medication. Without first consulting your physician, do not discontinue taking apixaban. Even if you feel good, keep taking apixaban. To avoid missing any apixaban doses, make careful to replenish your prescription before you run out of medicine. To assist prevent a blood clot from developing and leading to a stroke, your doctor may prescribe another anticoagulant (‘blood thinner’) if you need to stop taking apixaban.

You have the chance of developing a blood clot in or around your spine during an epidural, spinal anaesthesia, or spinal puncture while taking apixaban, which might leave you paralysed. Inform your doctor if you have a residual epidural catheter, have undergone spinal surgery, have undergone repeated epidural or spinal punctures, or have any of these conditions. If you are taking any of the following, let your physician and chemist know: Aspirin, anagrelide (Agrylin), ibuprofen (Advil, Motrin, and other NSAIDs), indomethacin (Indocin, Tivorbex), ketoprofen, and naproxen (Aleve, Anaprox, and other NSAIDs), heparin, cilostazol (Pletal), clopidogrel (Plavix), dipyridamole (Persantine), eptifibatide (Integrilin), ticagrelor (Brilinta), ticlopidine, tirofiban (Aggrastat), and warfarin (Coumadin, Jantoven) are some examples of medications that fall under this category. Call your doctor right away if you have any of the following symptoms: Loss of control over your bowels or bladder, muscle weakness (particularly in your legs and feet), or numbness or tingling in your legs.

Whenever you refill your prescription for apixaban, your doctor or chemist will provide you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the information and ask your doctor or chemist. The Medication Guide is also available on the manufacturer’s website or the Food and Drug Administration (FDA) website.

You should discuss the dangers of taking apixaban with your doctor.

Apixaban is used to treat people with atrial fibrillation (a condition in which the heart beats erratically, raising the risk of blood clots forming in the body and potentially causing strokes) who are not suffering from heart valve disease prevent strokes or blood clots. In patients undergoing hip or knee replacement surgery, apixaban is also used to prevent deep vein thrombosis (DVT), a blood clot that typically forms in the leg, and pulmonary embolism (PE), a blood clot that forms in the lung. After the initial course of treatment is finished, apixaban may be continued to prevent DVT and PE from occurring again. Factor Xa inhibitors are a group of medicines that includes apixaban. It functions by preventing the action of a certain natural chemical that aids in the formation of blood clots.

Apixaban is available as an oral tablet. It is often taken twice daily, with or without food. The first dosage of apixaban should be administered at least 12 to 24 hours after surgery if it is being used to prevent DVT and PE following hip or knee replacement. After a hip or knee replacement, apixaban is typically given for 35 days and for 12 days, respectively. Take apixaban every day at roughly the same time. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Administer apixaban exactly as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

The tablets can be crushed and mixed with water, apple juice, or applesauce if you are unable to swallow them whole. As soon as the mixture is ready, swallow it. You can also administer apixaban through several types of feeding tubes. Ask your doctor if you should use your feeding tube to administer this medication. Carefully adhere to your doctor’s instructions.

Even if you feel good, keep taking apixaban. Without first consulting your physician, do not discontinue taking apixaban. Your chance of developing a blood clot may increase if you stop taking apixaban.

Ask your doctor or chemist for more details if you believe this drug should be used for something else.

Before taking apixaban,

• If you have an allergy to apixaban, any other medications, or any of the chemicals in apixaban pills, inform your doctor and chemist right away. For a list of the ingredients, consult the Medication Guide or speak with your chemist.
• Inform your doctor and chemist about any other prescription and over-the-counter drugs, vitamins, and dietary supplements you are now taking or intend to take. Incorporate any of the following: Itraconazole (Onmel, Sporanox), ketoconazole (Nizoral), carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Teril), clarithromycin (Biaxin, in Prevpac); rifampin (Rifadin, Rimactane, in Rifadin, in Rifater); phenytoin (Dilantin, Phenytek); ritonavir (Norvir, in Kaletra); citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft) are examples of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), which include milnacipran (Fetzima, Savella), venlafaxine (Effexor), desvenlafaxine (Khedezla, Pristiq), and duloxetine (Cymbalta). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. Tell your doctor about all of the medications you are taking, including any not on this list, as many other drugs may also interact with apixaban.
• Please let your doctor know if you are taking any herbal supplements, especially St. John’s wort.
• You should be aware that apixaban may interact with some drugs that are used to treat strokes and other medical emergencies. You or a family member should disclose that you are taking apixaban to the physician or emergency department staff who treat you in the event of an emergency.
• If you have an artificial heart valve or severe, uncontrollable bleeding anyplace in your body, let your doctor know. Most likely, your doctor will advise against taking apixaban.
• Inform your physician if you are currently experiencing or have ever experienced any bleeding issues, kidney or liver problems, or antiphospholipid syndrome (APS), a condition that can result in blood clots.
• Inform your physician if you are nursing a baby, intend to get pregnant, or are already pregnant. Call your doctor if you become pregnant while taking apixaban.
• Inform the surgeon or dentist that you are taking apixaban if you are having surgery, including dental surgery. You could be instructed by your doctor to cease taking apixaban prior to the operation or treatment. Your doctor could recommend a different drug if you need to stop taking apixaban because you need to have surgery in order to prevent blood clots during this period. After your procedure, your doctor will advise you when to resume taking apixaban. Pay close attention to these guidelines.
• If you fall or hurt yourself, especially if you hit your head, call your doctor right away. Your physician might need to examine you.

Keep eating normally unless your doctor instructs you otherwise.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Some adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

• Bluish teeth
• Nosebleeds
• Lot of vaginal bleeding
• Brown, pink, or red urine
• Tarry stools that are crimson or black
• Blood or a substance that resembles coffee grounds when you cough or vomit
• Joint discomfort or swelling
• Headache
• Rash
• Stiffness or pain in the chest
• Swelling of the tongue or face
• Difficulty breathing
• Wheezing
• Feeling faint or dizzy

If you are cut or injured, it could take longer than usual for the bleeding to cease because apixaban stops blood from clotting normally. Additionally, this drug may make it easier for you to bleed or bruise. If bleeding or bruising is unusual, severe, or uncontrollable, call your doctor straight once.

Other negative effects of apixaban are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you suffer a serious side event.

Keep this medication tightly closed in the original container and out of the reach of children. Keep it at room temperature and out of the bathroom and away from light, excessive heat and moisture.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the ideal approach to get rid of your medicines. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling department in your city. If you do not have access to a take-back programme, visit the FDA’s Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for additional information.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.http://www.upandaway.org

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose signs could include the following:

• Uncommon bruising or bleeding
• Urine that is pink, brown, or red
• Tarry, crimson or black stools
• Vomiting or coughing up blood or what seems to be coffee grounds

Keep all of your doctor’s appointments.

No one else should take your medication. Any queries you may have regarding prescription refills should be directed to your chemist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.