Apixaban is a blood-thinning medicine that reduces the formation of harmful blood clots in your body.
This medicine is used to treat deep vein thrombosis (blood clots in the leg veins) and pulmonary embolism (blood clots in a lung artery).
It is also used to prevent clotting in the heart due to irregular heartbeats.
Apixaban is also used to prevent blood clots from forming after hip or knee replacement operation.
Take Apixaban exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Swallow the tablet whole with a glass of water. Try to take it at the same time each day.
If you have difficulty swallowing tablet(s), you may crush the tablet(s) and mix it with 60 mL of water, 5% glucose in water, apple juice or puree. Stir and drink immediately. You may take the mixture within 4 hours of preparation. Do not store the mixture for later use.
The dose of Apixaban will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- active bleeding
- liver disease which leads to an increased risk of bleeding
- certain conditions that may increase the risk of bleeding e.g. active or recent ulcers of the stomach or bowel, recent bleeding in your brain, recent brain or spinal injury, malignant tumours, blood vessel abnormalities
as Apixaban may not be suitable for you.
Do not take this medicine if you have recently undergone an operation involving the brain, spine or eye.
Do not take Apixaban with other blood-thinning medicines such as heparin and warfarin, except when changing your blood-thinning treatment.
Inform your doctor if you have the following conditions:
- have increased risk for bleeding
- active cancer
- weighing less than 60 kg
- have a prosthetic (surgically implanted) heart valve
- antiphospholipid syndrome (a disorder of the immune system that causes an increased risk of blood clots)
- kidney disease
- severe liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to the elderly. Elderly people may be more sensitive to the side effects.
If you are going for a procedure such as cardioversion (a procedure to normalise the heart rhythm), surgery wherein a spinal or epidural anaesthesia is to be injected into your back, or any dental work, inform your doctor or dentist that you are taking this medicine.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. complete blood count, blood clotting time, liver and kidney function) may be done while you are being treated with this medicine.
- Regular monitoring of signs and symptoms of blood loss may also be needed.
Apixaban may cause any of the following side effects: bleeding in your eyes, nose, gums, stomach or bowel, blood in urine, and nausea.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience severe bleeding or bleeding that cannot be controlled.
This medicine may cause the level of your red blood cells and platelets to drop.
Red blood cells carry oxygen around your body. A fall in the level of red blood cells may make you feel tired and worn out.
Platelets help your blood to clot when there is a cut in the skin. A fall in the level of your platelets may put you at risk of bleeding more than usual. Do not take part in activities where you may fall or get injured, such as contact sports. Alert your doctor if you get any unusual bruising (large bruises or several bruises, especially if the bruises appeared on their own) or bleeding that takes a long time to stop (for example, too much bleeding when you floss or brush your teeth).
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Apixaban with any other blood-thinning medicines such as heparin, enoxaparin, dalteparin, fondaparinux, warfarin, dabigatran, and rivaroxaban, except when changing your blood-thinning treatment.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat fungal infection e.g. itraconazole, ketoconazole, voriconazole, posaconazole
- ritonavir (medicine for HIV infection)
- other medicines used to prevent blood clots e.g. aspirin
- NSAIDs (medicine for pain and inflammation)
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
- rifampicin (medicine to treat TB, an infection known as tuberculosis)
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Apixaban.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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