Apixaban Tablets (Eliquis)

What is this medication?

APIXABAN (a PIX a ban) prevents and treats blood clots. It is also used to lower the risk of stroke in people with AFib (atrial fibrillation). It belongs to a group of medications called blood thinners.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Eliquis

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Antiphospholipid syndrome (APS)
• Bleeding problems
• Having surgery, an epidural, a spinal tap, or any other procedure that involves the area around your spine
• Kidney disease
• Liver disease
• Prosthetic heart valve
• An unusual or allergic reaction to apixaban, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

How should I use this medication?

Take this medication by mouth. Take it as directed on the prescription label at the same time every day. You can take it with or without food. If it upsets your stomach, take it with food. For your therapy to work as well as possible, take each dose exactly as prescribed on the prescription label. Do not skip doses. Skipping doses or stopping this medication can increase your risk of a blood clot or stroke. Keep taking this medication unless your care team tells you to stop.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as newborns for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

If a child vomits or spits up 30 minutes or less after taking their dose, repeat that dose. If the child vomits more than 30 minutes after taking their dose, do not give another dose. Give their next dose at their normal scheduled time. Talk to your care team if the child continues to vomit or spit up after taking their dose.

What may interact with this medication?

Do not take this medication with any of the following:

• Defibrotide
• Factor X
• Mifepristone
• Prothrombin complex concentrate

This medication may also interact with the following:

• Aspirin and aspirin-like medications
• NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
• Other medications that treat and prevent blood clots, such as clopidogrel, enoxaparin, dalteparin, heparin, warfarin
• Rifampin
• Ritonavir
• SNRIs, medications for depression, such as desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
• Some medications for fungal infections, such as itraconazole or ketoconazole
• Some medications for seizures, such as carbamazepine or phenytoin
• SSRIs, medications for depression, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
• St. John's wort

Other medications may affect the way this medication works. Talk with your care team about all the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. It is important to keep your scheduled visit. In children, this medication is dosed based on their weight. The dose will need to be adjusted by your care team as they grow and their weight changes. This ensures the child receives the correct dose.

You may need blood work done while you are taking this medication.

Avoid sports and activities that may cause injury while you are taking this medication. Severe falls or injuries can cause unseen bleeding. Be careful when using sharp tools or knives. Consider using an electric razor. Take special care brushing or flossing your teeth. Report any injuries, bruising, or red spots on the skin to your care team.

Before having surgery, dental work, or another procedure, tell your care team that you are taking this medication.

People who take this medication and have a spinal procedure are at risk of forming a blood clot in the space around the brain or spinal cord. This could cause paralysis (not being able to move). The risk is higher in people who have spinal problems or injuries, have had spinal surgery in the past, and for those with a tube (catheter) in their back. Taking other medications that also affect bleeding, such as NSAIDs or other blood thinners, can also increase the risk. Your care team will watch you closely. Let them know right away if you feel pain, tingling, or numbness in your legs or feet.

Wear a medical ID bracelet or chain. Carry a card that describes your condition. List the medications and doses you take on the card.

Talk to your care team if you may be pregnant. Serious fetal side effects, such as bleeding, may occur if you take this medication during pregnancy. There are benefits and risks to taking medications during pregnancy. Your care team can help you find the option that works for you.

Talk to your care team before breastfeeding. Changes to your treatment plan may be needed.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
• Bleeding in the brain—severe headache, stiff neck, confusion, dizziness, change in vision, numbness or weakness of the face, arm, or leg, trouble speaking, trouble walking, vomiting
• Heavy periods

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

• Headache
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or expired:

• Take the medication to a take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix it with cat litter, dirt, coffee grounds, or another unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What foods should I avoid while on Eliquis?

Certain foods may increase the concentration of Eliquis^® in your blood and your risk of bleeding. If possible, you should generally avoid some herbal teas, supplements and spices that may increase or decrease the concentration of the drug. This can make it stronger or weaker.

Foods that may increase the concentration of Eliquis in your system include:

• Grapefruit juice
• Lime juice
• Oats
• Mangoes
• Wild blueberries
• Fish oil

Herbs and spices that may increase or decrease the concentration of Eliquis in your system include:

• Ginseng
• St. John’s wort
• Chamomile
• Rosemary
• Garlic
• Cinnamon
• Ginger

What happens if you take Eliquis only once a day?

Taking this medicine only once a day may increase your risk of blood clots and stroke. It’s important that you take it every 12 hours without missing any doses. It has a half-life of 12 hours. That means half of the drug is out of your body in 12 hours.

What does Eliquis look like?

This medicine may be a round, yellow tablet or an oval, pink tablet. The appearance depends on the dose.

What dosage strengths and forms does it come in?

You can get it in 2.5 mg (milligram) and 5 mg tablets. Your healthcare provider will base your dose on several factors, like age, weight, kidney function and the reason for taking this medicine.

Can I drink alcohol with Eliquis?

You can drink some alcohol while taking this medicine. But you should limit alcohol intake to 14 units in one week for males and seven units in one week for females. One drink is typically one to three units, depending on the size of the glass and type of drink. Heavy drinking may increase your risk of bleeding.

What’s known about Eliquis and overdose?

Overdose symptoms may include red or black poop and red or brown pee. You may also throw up blood. If you take too much of this medicine, contact your healthcare provider right away. There’s an FDA-approved antidote, andexanet alfa, that can reverse it in certain high-risk situations. Activated charcoal from a provider may also help.