Eliquis (Apixaban) - Oral

Warning:

Warning: Stopping Eliquis (apixaban) early can increase the risk of bleeding events. To reduce this risk, your healthcare provider may direct you to take a different anticoagulant medication. Additionally, apixaban users receiving neuraxial anesthesia or undergoing spinal puncture may be at an increased risk of spinal or epidural hematomas. Therefore, always let your healthcare provider know that you are taking this medication, especially before a medical procedure.

What Is Eliquis?

Eliquis (apixaban) is a prescription anticoagulant (blood thinner) used to treat and prevent certain types of blood clots and reduce the risk of stroke in adults.

It interferes with the formation of blood clots by inhibiting the factor Xa (FXa) enzyme. This enzyme promotes blood clots through its interaction with thrombin and prothrombinase, which are proteins that play a role in blood clot development.

Apixaban is sometimes prescribed off-label (for uses not approved by the Food and Drug Administration [FDA]) at different doses.

This medication is available as a tablet to be taken by mouth.

Drug Facts

Generic Name: Apixaban

Brand Name(s): Eliquis

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Anticoagulant

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Apixaban

Dosage Form(s): Tablet

What Is Eliquis Used For?

Eliquis is prescribed for daily use to prevent or treat blood clots. It is approved for:

  • Nonvalvular atrial fibrillation (NVAF): Apixaban is prescribed to reduce the risk of stroke or other blood clots. Atrial fibrillation is an irregular heart rhythm that can allow blood clots to form in the heart, potentially traveling to arteries elsewhere in the body, including the brain. 
  • After hip or knee replacement surgery: Apixaban can prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) after these procedures. Physical changes and immobility after these surgeries can increase the risk of a DVT (blood clot in the veins of the legs or arms). A DVT can dislodge and travel to the lungs, potentially causing difficulty breathing, permanent lung damage, or death.
  • Existing DVT and PE
  • Recurrent DVT or PE prevention

How to Take Eliquis

Eliquis is meant to be taken by mouth twice a day for a duration of weeks, months, or longer. The exact dosage of Eliquis prescribed may differ based on your diagnosis. You can take it with or without food.

Storage

Keep this medication in its original container and out of the reach of children and pets. Do not store it in the bathroom.

You should keep it at a temperature of 68 F to 77 F, although it can be kept temporarily at temperatures as low as 59 F and as high as 86 F.

Off-Label Uses

Apixaban is sometimes prescribed off-label to treat or prevent blood clots in other conditions besides those that are formally approved.

Off-label uses include:

Sometimes, apixaban is prescribed at a lower than recommended dose for NVAF. For its approved indications and off-label, it is also sometimes given at higher or lower than the recommended dose and/or for a duration different than what's recommended.

How Long Does Eliquis Take to Work?

Eliquis is absorbed rapidly and starts working three to four hours after taking it. If you stop taking it, its effects will wear off in about 24 hours.

What Are the Side Effects of Eliquis?

Eliquis can cause several side effects, even when it’s taken as prescribed. Taking it irregularly or inconsistently can increase your risk of adverse events.

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Bleeding is the most common side effect associated with Eliquis. This can manifest as prolonged bleeding from a cut or bruising after a minor bump or without apparent injury.

Severe Side Effects

Call your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and symptoms can include the following:

  • Severe skin rash: May progress and cause skin loss, dehydration, bleeding, or infection 
  • Allergic reaction: Symptoms can include chest pain, wheezing, trouble breathing, chest tightness, swelling of the face or tongue, dizziness 
  • Spinal hematoma (bleeding near the spinal cord): Can cause weakness or changes in sensations, potentially causing paralysis 
  • Bleeding in the brain: Can begin with headaches, dizziness, or vision changes, potentially causing neurological deficits or death
  • Gastrointestinal bleeding: Can cause blood in the stool or vomiting blood, with potentially dangerous amounts of blood loss

Get prompt medical attention if you develop any of these issues.

Long-Term Side Effects

Eliquis can also cause long-term complications, including:

  • Permanent neurological deficits, such as weakness, vision loss, difficulty speaking, or impaired thinking, can occur due to bleeding in the brain. 
  • Permanent weakness of the arms and legs and/or incontinence can occur after bleeding in or around the spinal cord.

Report Side Effects

Eliquis may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Eliquis Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For prevention of deep venous thrombosis (hip replacement surgery):
      • Adults—2.5 milligrams (mg) two times a day, for 35 days. The first dose should be taken 12 to 24 hours after surgery.
      • Children—Use and dose must be determined by your doctor.
    • For prevention deep venous thrombosis (knee replacement surgery):
      • Adults—2.5 milligrams (mg) two times a day, for 12 days. The first dose should be taken 12 to 24 hours after surgery.
      • Children—Use and dose must be determined by your doctor.
    • For prevention of reoccurring deep venous thrombosis and pulmonary embolism:
      • Adults—2.5 milligrams (mg) two times a day, after at least 6 months of treatment for deep venous thrombosis or pulmonary embolism.
      • Children—Use and dose must be determined by your doctor.
    • For prevention of strokes and blood clots in patients with nonvalvular atrial fibrillation:
      • Adults—5 milligrams (mg) two times a day.
      • Adults with 2 of the following characteristics: 80 years of age and older, body weight of 60 kilograms (kg) or less, or kidney problems—2.5 mg two times a day.
      • Children—Use and dose must be determined by your doctor.
    • For treatment of deep venous thrombosis and pulmonary embolism:
      • Adults—At first, 10 milligrams (mg) two times a day, for the first 7 days. Then, your doctor may give you 5 mg two times a day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used. Therefore, it is important for users to be aware of the following when taking Eliquis:

Pregnancy or Breastfeeding

There is limited data available for Eliquis use during pregnancy. Talk to your healthcare provider if you are pregnant or plan to become pregnant while on this medication, especially if you have abnormal uterine bleeding. It is also unknown if apixaban passes into breast milk; therefore, breastfeeding is not recommended while taking this drug.

Kidney Problems

A lower dose may be prescribed for people who have at least two of the following characteristics:

  • 80 years or older
  • Body weight less than or equal to 60 kilograms (132 pounds)
  • Serum creatinine greater than or equal to 1.5 milligrams per deciliter

Missed Dose

If you miss a dose, take it as soon as you remember. Do not double up on doses to make up for a missed dose. If you have trouble remembering when to take it, try using a pillbox or a medication app reminder.

Overdose: What Happens If I Take Too Much Eliquis?

Taking too much Eliquis can cause dangerous bleeding and blood loss. If you take more Eliquis than prescribed, immediately talk to your healthcare provider about what you should do next.

Seek urgent medical attention if you experience:

  • Back pain
  • Severe headaches
  • Lightheadedness
  • Vomiting blood
  • Bloody stool
  • Changes in consciousness

Management of an overdose can include:

  • Close medical observation 
  • Treatment of symptoms, which may include a blood transfusion 
  • Administration of activated charcoal
  • Administration of Andexxa, prescription medication that reverses the anti-factor Xa activity of Eliquis

What Happens If I Overdose on Eliquis?

If you think you or someone else may have overdosed on Eliquis, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Eliquis, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects.

This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Make sure any doctor who treats you knows that you are using this medicine. You may need to stop using this medicine for several days before having surgery, including dental procedures.

Do not suddenly stop using this medicine without asking your doctor. You might have a higher risk of stroke after you stop using this medicine.

You may bleed and bruise more easily while you are using this medicine. Be extra careful to avoid injuries. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Gently brush and floss your teeth. Be careful when using sharp objects, including razors and fingernail clippers. Avoid picking your nose. If you need to blow your nose, blow it gently.

Check with your doctor right away if you have any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, headache, dizziness, or weakness, pain, swelling, or discomfort in a joint, pinpoint red spots on your skin, unusual nosebleeds, or unusual vaginal bleeding that is heavier than normal. These may be signs of bleeding problems.

This medicine may increase risk of blood clot in the spine or epidural area, which may lead to long-term or permanent paralysis. This is more likely to occur if you have an epidural catheter placed in your back, are taking NSAID or blood clotting medicine, a history of repeated epidural punctures or problems with your spine, or have had surgery on your spine. Tell your doctor right away if you have tingling, numbness, or muscle weakness, especially in your legs and feet.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Eliquis?

You should not take Eliquis if you have:

  • Active pathologic bleeding
  • Severe hypersensitivity to apixaban

Eliquis is also not recommended in people who have prosthetic heart valves or a condition called triple-positive antiphospholipid syndrome.

What Other Medications Interact With Eliquis?

Taking other blood thinners, including FXa inhibitors, antiplatelet agents, and anticoagulants, could increase the risk of bleeding. Additionally, taking nonsteroidal anti-inflammatory drugs (NSAIDs) with Eliquis raises the risk of bleeding. Let your healthcare provider know if you are taking any of these medications before starting Eliquis.

Additionally, taking Eliquis with strong cytochrome P450 3A4 (CYP3A4) inhibitors and combined P-glycoprotein (P-gp) can increase blood levels of Eliquis, increasing the risk for side effects. These medications include:

Conversely, using combined P-gp medications and strong CYP3A4 inducers can reduce blood levels of Eliquis, making it less effective. These medications include:

This is not a complete list of potential drug interactions. Before starting Eliquis, share your current medication use (prescription and OTC) and any vitamins or herbal supplements you take with your healthcare provider.

What Medications Are Similar?

Several medications are available to prevent and treat blood clots, with several different mechanisms of action.

Other FXa inhibitors similar to Eliquis include:

Frequently Asked Questions

  • What is Eliquis used for?

    Eliquis is approved to:

    • Prevent strokes and other blood clots due to nonvalvular atrial fibrillation
    • Prevent blood clots after hip or knee replacement
    • Treat deep vein thrombosis (DVT) or pulmonary embolus (PE)
    • Prevent recurrent DVT or PE after treatment of an initial DVT or PE
  • How does Eliquis work?

    Eliqiuis treats and prevents blood clots by inhibiting factor Xa, an enzyme that naturally promotes blood clots in the body.

  • What drugs should not be taken with Eliquis?

    Other blood thinners can increase the risk of bleeding if used with Eliqiuis, as can NSAIDs. So, let your healthcare provider know if you are taking those medications. Additionally, drugs classified as combined P-gp, strong CYP3A4 inhibitors, and strong CYP3A4 inducers can alter the level of Eliquis in the body.

  • How long does it take for Eliquis to work?

    Eliquis can start having an effect on the body’s blood clotting ability within a few hours. However, it may take several days of consistent dosing to have the desired therapeutic effect. Some effects of Eliqiuis may remain for several days or up to a week after you stop taking it.

  • What are the side effects of Eliquis?

    This medication can cause bleeding, which may range from mild to severe. It can also cause a severe skin rash or a serious allergic reaction. Tell your healthcare provider about any adverse effects.

  • How do I stop taking Eliquis?

    Stopping Eliquis abruptly or when you still need to take it can increase your risk of developing a blood clot. Your healthcare provider will instruct you when and how to stop taking Eliquis and whether you need to replace it with another blood thinner. You might need to stop taking Eliquis due to side effects, but discontinuation should be done under medical supervision.

How to Stay Healthy While Taking Eliquis

It's important to be mindful of taking care of yourself while taking Eliquis to reap the maximum benefits while reducing the risk of side effects. The most important considerations with this medication are:

  • Bleeding risk: If you take Eliquis, try to avoid injuries. This means you should not participate in contact sports or other activities that could cause falling, bleeding, or bruising. 
  • Blood clots: Eliquis is prescribed for people at risk of blood clots. Make sure you are familiar with the signs of a stroke, heart attack, DVT and PE so that you can get medical attention immediately if you experience a blood clot. 
  • Use as prescribed: Make sure to take Eliquis as prescribed by your healthcare provider and get your refills on time.
  • Diet: Foods that contain high amounts of vitamin K might affect your tendency for bleeding or blood clots. The foods highest in vitamin K are liver and green leafy vegetables. Try to maintain consistency in your diet, and do not take any vitamin K supplements unless directed by your healthcare provider.

If you have atrial fibrillation, ensure you are getting proper surveillance of your heart condition so your healthcare provider can adjust your treatments as necessary.

Tell your healthcare provider and pharmacist about any new medical conditions you are diagnosed with while taking Eliquis, as it may affect how the drug works. Be sure to share your use of medications (prescription and OTC), vitamins, and herbal supplements.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.