Eliquis Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Eliquis Tablet contains apixaban, an anticoagulant (blood thinner) that works by blocking Factor Xa, a key substance involved in blood clotting. It is used to prevent stroke and blood clots in adults with certain irregular heartbeats, to treat and prevent blood clots in the legs and lungs, and to prevent clots after hip or knee replacement surgery. It is also used in children after at least 5 days of initial anticoagulant treatment. Common risks include bleeding, and it should be used exactly as directed by a doctor.

What is Eliquis Tablet

Eliquis contains the active substance apixaban and belongs to a group of medicines called anticoagulants (blood thinners). It works by blocking Factor Xa, which is an important component of blood clotting.

Eliquis Tablet uses

• Prevent stroke and blood clots (systemic embolism) in adults with an irregular heartbeat (atrial fibrillation) not caused by a heart valve problem
• Treat blood clots in the veins of the legs (deep vein thrombosis, DVT) and in the blood vessels of the lungs (pulmonary embolism, PE)
• Prevent DVT and PE from happening again after treatment for blood clots
• Prevent blood clots (DVT) forming after hip or knee replacement surgery
• Treat blood clots in the veins of the legs and lungs (venous thromboembolism) in children after at least 5 days of initial anticoagulant treatment, and to reduce the risk of them happening again

Benefits of Eliquis Tablet

• Lowers the chance of having a stroke or systemic embolism in people with atrial fibrillation
• Reduces the risk of blood clots forming in the legs and lungs after hip or knee replacement surgery
• Effectively treats existing blood clots (DVT and PE)
• Reduces the risk of blood clots happening again after initial treatment

How Eliquis Tablet works

Apixaban blocks a clotting substance in the blood called Factor Xa. By stopping Factor Xa from working, it prevents the blood from forming clots as easily.

Eliquis Tablet dosage

Swallow the tablet with a drink of water. It can be taken with or without food. Try to take the tablets at the same times every day to have the best treatment effect, two times every day. Do not change your dose or stop taking the medicine unless your doctor tells you to.

If you have difficulty swallowing the tablet whole, talk to your doctor about other ways to take it; the tablet may be crushed and mixed with water, glucose/dextrose solution, apple juice, or apple puree immediately before taking it.

If you miss a dose, take it as soon as you remember on the same day, then continue with your usual twice-daily schedule; do not take two doses at the same time to make up for a missed dose.

Do not stop taking this medicine without talking to your doctor first, because stopping treatment too early can increase the risk of a blood clot or stroke.

For children who cannot swallow tablets, special oral suspension forms are used according to the child's body weight, and doses should be given exactly as instructed by the child's healthcare provider. If a child vomits or spits up within 30 minutes after taking a dose, repeat the dose; if this happens more than 30 minutes after the dose, do not repeat it and continue with the next scheduled dose.

Tell all your healthcare providers and dentists that you are taking this medicine before any surgery, medical, or dental procedure, as it may need to be temporarily stopped.

Available forms and strengths

• Film-coated tablets (2.5 mg and 5 mg)
• Tablet for oral suspension (0.5 mg)
• Sprinkle capsule for oral suspension (0.15 mg)
• Oral solution (0.4 mg/mL, used in some paediatric studies)

Side effects of Eliquis Tablet

Common

• Bleeding (including in the eyes, stomach, bowel, from the rectum, nose, gums, and in the urine)
• Bruising and swelling
• Anaemia (which may cause tiredness or paleness)
• Low blood pressure (which may make you feel faint or have a quickened heartbeat)
• Nausea (feeling sick)
• Increase in a liver enzyme called gamma-glutamyltransferase (GGT) shown on blood tests

Serious

• Bleeding in the brain or spinal column
• Bleeding into the abdomen or from the vagina
• Bright red blood in the stools
• Reduced number of platelets in the blood (which can affect clotting)
• Abnormal liver function or increased liver enzymes
• Yellowing of the skin and eyes from increased bilirubin
• Allergic reactions (hypersensitivity) causing swelling of the face, lips, mouth, tongue and/or throat and difficulty breathing
• Skin rash that may form blisters and look like small targets (erythema multiforme)
• Blood vessel inflammation (vasculitis)
• Bleeding in the kidney with blood in the urine, sometimes affecting kidney function

Warnings and precautions

• Stopping this medicine increases the risk of stroke or blood clots forming. Do not stop taking it without talking to your doctor first.
• This medicine can cause serious or life-threatening bleeding, especially when combined with other medicines that increase bleeding risk such as aspirin, NSAIDs, warfarin, heparin, clopidogrel, or certain antidepressants.
• People who receive spinal injections or spinal taps while taking this medicine have a risk of a blood clot forming around the spinal cord, which can cause long-term or permanent paralysis.
• This medicine should not be used by people with artificial (prosthetic) heart valves.
• This medicine should not be used by people with antiphospholipid syndrome, especially those with a positive triple antibody test.
• This medicine may need to be stopped before surgery or an invasive procedure because of bleeding risk; timing should be decided by your doctor.
• This medicine is not recommended for people with severe pulmonary embolism who are unstable or may need clot-dissolving treatment or surgery to remove the clot.
• It is not known if this medicine will harm an unborn baby. It should generally be avoided during pregnancy, and you should contact your doctor immediately if you become pregnant while taking it.
• It is not known if this medicine passes into breast milk. A decision must be made whether to stop breastfeeding or stop the medicine, considering the benefits of each.
• Caution or dose changes may be needed for people with kidney problems, and the medicine is not recommended for those with very severe kidney disease or on dialysis.
• This medicine should not be used in people with liver disease that causes bleeding problems, and should be used with caution in those with mild or moderate liver impairment. It is not recommended for those with severe liver impairment.
• This medicine has not been shown to affect your ability to drive or use machines.

Storage

• Store at or below 30°C (or per US labeling, at room temperature between 68°F to 77°F / 20°C to 25°C).
• Keep out of the sight and reach of children.
• Do not use after the expiry date stated on the carton and blister.
• Do not throw away any medicines via wastewater or household waste; ask your pharmacist how to dispose of medicines you no longer use.

When to see a doctor

• Get medical help right away if you notice unusual or heavy bleeding, bruising that lasts a long time, or bleeding that will not stop.
• Get medical help right away if your urine turns red, pink, or brown, or if your stools are red or black and tarry.
• Get medical help right away if you cough up blood or blood clots, or if you vomit blood or vomit that looks like coffee grounds.
• Get medical help right away if you have sudden back pain, tingling, numbness, or muscle weakness, especially in the legs and feet, or loss of bowel or bladder control, as these may be signs of a spinal blood clot.
• Contact your doctor immediately if you experience swelling of the face, lips, mouth, tongue, or throat, or difficulty breathing, as these may be signs of a serious allergic reaction.
• Call your healthcare provider right away if you fall or injure yourself, especially if you hit your head, as you may need to be checked for internal bleeding.
• Tell your doctor immediately if you have taken more than the prescribed dose.

Alternatives

Patients may be switched between Eliquis and other anticoagulants such as heparin or vitamin K antagonists like warfarin, under medical supervision. Switching from a vitamin K antagonist such as warfarin to Eliquis is described as a specific procedure.

• Rivaroxaban
• Dabigatran