Apixaban Tablets (Eliquis)

What is this medication?

APIXABAN (a PIX a ban) prevents or 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 antibody syndrome
• Bleeding disorder
• History of bleeding in the brain
• History of blood clots
• History of stomach bleeding
• Kidney disease
• Liver disease
• Mechanical heart valve
• Spinal surgery
• An unusual or allergic reaction to apixaban, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth. 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. 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.

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. Special care may be needed.

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.

What may interact with this medication?

This medication may interact with the following:

• Aspirin and aspirin-like medications
• Certain medications for fungal infections like itraconazole and ketoconazole
• Certain medications for seizures like carbamazepine and phenytoin
• Certain medications for blood clots like enoxaparin, dalteparin, heparin and warfarin
• Clarithromycin
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Rifampin
• Ritonavir
• St. John's wort

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 healthcare professional for regular checks on your progress. You may need blood work done while you are taking this medication. Your condition will be monitored carefully while you are receiving this medication. It is important not to miss any appointments.

Avoid sports and activities that might cause injury while you are using 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 healthcare professional.

If you are going to need surgery or other procedure, tell your healthcare professional that you are taking this medication.

Wear a medical ID bracelet or chain. Carry a card that describes your disease and details of your medication and dosage times.

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, or 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 the 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

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 medication 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 in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other 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 are the foods to avoid while on Eliquis®?

Certain foods may increase the concentration of Eliquis® in your blood and your risk of bleeding. Some herbal teas, supplements and spices 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

• 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

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

Does Eliquis® cause depression or anxiety?

A study didn’t find a link between Eliquis® and developing depression. Other studies haven’t looked at whether Eliquis® causes anxiety.

Does Eliquis® make you tired?

It can if you develop anemia while taking Eliquis®. Talk with your healthcare provider if you’re tired while on Eliquis®. They can find out if you have anemia and treat you for it.

Does Eliquis® cause weight gain?

Studies haven’t focused on the topic of weight gain from Eliquis®. But if you search online, you’ll see that people claim weight gains or losses are from the drug.

How long does Eliquis® stay in your system?

After 12 hours, 50% of a dose is still in your system. It decreases from there until it’s gone in about three days. You have to stop taking Eliquis® 24 to 48 hours before surgery so you don’t bleed too much. Don’t stop taking Eliquis® unless your provider tells you to stop.

A note from Cleveland Clinic

Taking a blood thinner is more convenient than it used to be, and it’s nice to have options. But you still need to pay attention to the instructions on the label. If you have questions about your medication, ask your healthcare provider. Having the right amount of Eliquis® in your body matters. You might want to set a timer on your phone to remind you when it’s time to take it.