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.
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. Try to take it at the same time each day.
If you have difficulty swallowing whole tablet(s), you may crush the tablet(s) and mix it with 60 mL of water, or 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 this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type of 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
- other diseases or conditions that may increase the risk of bleeding e.g. history of stomach ulcers, recent brain, spine or eye injury/surgery; tumours, blood vessel abnormalities
as this medicine may not be suitable for you.
Do not take Apixaban with any other blood-thinning medicines (oral or injectable such as warfarin and heparin) except when changing your blood-thinning treatment.
Inform your doctor if you have the following conditions:
- bleeding problems or have increased risk for bleeding (e.g. weighing less than 60 kg, high blood pressure)
- have prosthetic (surgically implanted) heart valve
- heart disease
- lung problem
- severe kidney disease or undergoing dialysis
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Apixaban to an elderly.
If you are going for a procedure such as cardioversion (a procedure to normalise the heart rhythm), or surgery where spinal or epidural anaesthesia is injected into your back, or any dental work, inform your doctor or dentist that you are taking this medicine.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly. He may need to perform blood tests to make sure that your liver and kidney function is normal before you take this medicine and while taking this medicine.
Apixaban may cause bleeding in your eyes, nose, gums, mouth, stomach, bowel, vagina and urine, nausea, skin rashes, itching, and hair loss.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes, mouth or throat
- unusual bleeding or bruising, tiredness, paleness
- prolonged bleeding with leg weakness or numbness and bladder or bowel problem
Apixaban 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 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 (oral or injectable 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 for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
- medicines to treat fungal infections e.g. itraconazole, ketoconazole, voriconazole
- rifampicin (medicine to treat tuberculosis or TB)
- clarithromycin (antibiotic)
- ritonavir (medicine for HIV infection)
- St. John’s wort (herbal remedy for depression)
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 consumption of grapefruit juice while you are being treated with Apixaban.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.