Apixaban is a direct oral anticoagulant doctors prescribe to prevent clots. You probably know it as Eliquis. It lowers the risk of stroke in atrial fibrillation and treats or prevents deep vein thrombosis and pulmonary embolism. The drug works by blocking factor Xa, a key step in clot formation.
Typical doses: for atrial fibrillation the usual dose is 5 mg twice daily; some people take 2.5 mg twice daily if they meet age, weight, or kidney criteria. For treating DVT or PE the common start is 10 mg twice daily for seven days, then 5 mg twice daily. Apixaban is not for people with mechanical heart valves and is usually avoided in pregnancy. Your clinician picks the right dose based on your kidney function, age, weight, and other meds.
Apixaban doesn't need routine blood monitoring like warfarin, so no regular INR checks. But your doctor will still check kidney function before starting and periodically after that. If you have severe kidney disease, the dose or choice of blood thinner may change.
Bleeding is the main risk. Watch for unusual bruising, nosebleeds that don't stop, black or bloody stools, coughing up blood, or heavy vaginal bleeding. If you suspect major bleeding or feel faint, get emergency care. There's a specific reversal agent called andexanet alfa in some hospitals; otherwise, doctors may use prothrombin complex concentrate in emergencies.
Apixaban interacts with some drugs. Strong inhibitors of CYP3A4 and P-glycoprotein, like ketoconazole, itraconazole, or ritonavir, can raise apixaban levels and increase bleeding risk. Strong inducers such as rifampin or St. John's wort can lower levels and reduce effectiveness. Combining apixaban with NSAIDs, aspirin, or other blood thinners raises bleeding risk too.
Before any procedure, tell your surgeon or dentist you take apixaban. Many patients stop the drug 24 to 48 hours before surgery depending on bleeding risk and kidney function. Never stop anticoagulation without talking to the prescriber; they'll balance clot vs bleed risk and may arrange a temporary switch.
Missed dose? Take it as soon as you remember the same day; do not double doses. Carry a card or wear medical ID that states you're on apixaban. Keep all prescription and over-the-counter meds in the pharmacist's review; pharmacists can spot dangerous interactions quickly.
Finally, talk with your clinician about cost options and whether generic apixaban is suitable for you. If you shop online for meds, use regulated pharmacies, check for proper prescriptions, and avoid sites that don't require a prescription. If anything feels off or a side effect appears, call your healthcare team — quick action prevents small problems from becoming big ones.
Limit alcohol while on apixaban; it can worsen bleeding and interact with other meds. Check with your doctor before starting herbal supplements like ginkgo or garlic concentrated extracts — they can raise bleeding risk. Keep follow-up appointments, bring a list of current medicines, and ask for written instructions about stopping and restarting the drug around procedures. Carry emergency contact info.
In my latest blog post, I delve into the world of Apixaban, a popular anticoagulant, and its implications for invasive procedures. It's important to understand both the risks and benefits associated with its use. While Apixaban significantly reduces the risk of stroke and blood clots, it can also increase the risk of bleeding during invasive procedures. However, with proper timing and medical guidance, these risks can be minimized. Read on to know more about this delicate balance between preventing clots and managing bleeding risks.