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Pregnancy: There are no data from the use of apixaban in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity (see Pharmacology: Toxicology: Preclinical Safety Data under Actions). As a precautionary measure, it is preferable to avoid the use of apixaban during pregnancy
Breast-feeding: It is unknown whether apixaban or its metabolites are excreted in human milk. Available data in animals have shown excretion of apixaban in milk (see Pharmacology: Toxicology: Preclinical Safety Data under Actions). A risk to the suckling child cannot be excluded.
A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from apixaban therapy taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman.
Fertility: Studies in animals dosed with apixaban have shown no effect on fertility (see Pharmacology: Toxicology: Preclinical Safety Data under Actions).
