Apixaban
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
NO
Pharmaceutical Class
Factor Xa Inhibitor
Controlled Drug Substance
No
Apixaban
Summary
Apixaban is primarily used to prevent blood clots in people with atrial fibrillation, a heart condition that increases the risk of stroke. It's also used after hip or knee replacement surgery to reduce the risk of blood clots forming in the legs or lungs.
Apixaban is a blood thinner that works by inhibiting a specific clotting factor in your blood, known as Factor Xa. This makes it harder for blood clots to form, thus reducing the risk of strokes and other clot-related complications.
Apixaban is taken orally, usually twice a day. The exact dosage and duration of treatment depend on the condition being treated. For instance, after hip replacement surgery, it's typically taken for about 35 days, and after knee replacement, for about 12 days.
Common side effects of Apixaban include nausea, vomiting, diarrhea, and abdominal pain. It can also cause headaches, insomnia, and unusual tiredness or weakness. Less common side effects include changes in appetite, mood swings, and cognitive changes like confusion or decreased alertness.
It's crucial not to stop taking Apixaban suddenly, as this can increase the risk of blood clots. The medicine can cause bleeding, especially in the stomach and intestines. Also, if you're allergic to Apixaban, have a history of severe bleeding, or are pregnant or breastfeeding, you should not take this medication.
Indications and Purpose
How does Apixaban work?
Apixaban is a blood thinner that works by stopping a blood clotting protein (Factor Xa) from doing its job. This prevents blood clots from forming. It doesn't directly affect platelets (another part of blood clotting), but it does indirectly help prevent clots that platelets might cause. Although it does slightly change some blood tests (PT, INR, aPTT), these tests aren't very good at showing how well the medicine is working.
Is Apixaban effective?
Apixaban has been shown to be effective in preventing strokes and blood clots. In the ARISTOTLE trial, it reduced the risk of stroke or systemic embolism by 21% compared to warfarin, with fewer major bleeding incidents. Similarly, the AVERROES trial demonstrated that apixaban was more effective than aspirin in high-risk patients. Overall, studies indicate that apixaban not only works well but also has a better safety profile than traditional treatments like warfarin and aspirin.
What is Apixaban?
Apixaban is a medicine that helps prevent blood clots in people with an irregular heartbeat or those who have had hip or knee replacement surgery. It works by stopping clots from forming in the blood.
Directions for Use
For how long do I take Apixaban?
After hip replacement surgery, you'll take the blood thinner apixaban for about a month and a half (35 days). For knee replacement, it's a shorter time, about 12 days. The medicine continues to work to prevent blood clots for at least a full day after your last dose.
How do I dispose of Apixaban?
If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so it doesn't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag, and throw it away.
How do I take Apixaban?
Take your apixaban pills twice a day, exactly as your doctor tells you. You can take them with or without food.
How long does it take for Apixaban to start working?
Apixaban, a blood thinner, typically starts working within 2 to 4 hours after taking it. It reaches its peak effectiveness around 3 to 4 hours post-dose. This medication helps prevent blood clots by inhibiting a specific clotting factor in the blood, making it take longer for clots to form
How should I store Apixaban?
Keep your apixaban pills at room temperature, somewhere between 68 and 77 degrees Fahrenheit (or 20 and 25 degrees Celsius). Make sure kids can't get to them.
What is the usual dose of Apixaban?
The usual adult dose of Apixaban is 5 mg taken orally twice daily. For adults with certain conditions like age over 80, body weight under 60 kg, or serum creatinine over 1.5 mg/dL, the dose is reduced to 2.5 mg twice daily. Apixaban is not recommended for use in children as safety and effectiveness have not been established.
Warnings and Precautions
Can Apixaban be taken safely while breastfeeding?
Apixaban is a blood thinner that can pass into breast milk. It's not known if apixaban is safe for breastfed babies, so breastfeeding is not recommended while taking apixaban tablets. Talk to your doctor about whether to take apixaban tablets or breastfeed. It's not safe to do both.
Can Apixaban be taken safely while pregnant?
Apixaban is usually not recommended during pregnancy because of possible risks. While animal studies didn’t show major harm, there isn’t enough human data to be sure it’s safe. It can cause issues like bleeding in the uterus, which might harm the baby. Because of these concerns, doctors generally advise against using Apixaban during pregnancy to protect both the mother and the developing fetus.
Can I take Apixaban with other prescription drugs?
Taking apixaban with other medicines that increase bleeding risk, such as aspirin or ibuprofen, blood thinners, or steroids, can increase your chance of bleeding.
Does Apixaban have adverse effects?
Adverse effects, which are unwanted reactions to a medicine, can occur with empagliflozin. Common effects include urinary tract infections, which affect up to 9% of users, and genital yeast infections, especially in women. These can cause itching and unusual discharge. The medicine may increase urination, leading to dehydration, which means your body lacks enough fluids and might cause dizziness. A rare but serious effect is ketoacidosis, which is a dangerous acid buildup in the blood and needs immediate medical attention. Severe allergic reactions, kidney problems, or Fournier's gangrene, which is a serious genital infection, are very rare. Always inform your doctor about any new or worsening symptoms while on empagliflozin.
Does Apixaban have any safety warnings?
Empagliflozin has important safety warnings you should know about. This medication can increase your risk of diabetic ketoacidosis, which is a dangerous buildup of acids in your blood. This can happen even when your blood sugar is normal, especially if you miss insulin doses or get sick. If you experience nausea, vomiting, stomach pain, or breathing problems, get emergency help. Empagliflozin can cause dehydration, which means your body doesn't have enough fluids. This may lead to low blood pressure or kidney problems. Drink plenty of water while taking this medicine. Serious urinary tract infections, which are infections in the system that removes urine from your body, can occur. Watch for painful urination, fever, or back pain. Although rare, this medication can cause necrotizing fasciitis, which is a serious bacterial infection in the genital area requiring immediate medical attention. Genital yeast infections are common with empagliflozin. Regular foot care is important as this medicine may increase amputation risk in some patients. Stop taking the medicine and seek help if you develop signs of an allergic reaction.
Is Apixaban addictive?
Empagliflozin is not addictive or habit-forming. This medication doesn't cause dependency or withdrawal symptoms when you stop taking it. Empagliflozin works by affecting your kidneys to help remove sugar through urine. This mechanism doesn't affect brain chemistry in ways that could lead to addiction. You won't experience cravings for this medication or feel compelled to take more than prescribed. Unlike some medications that can cause psychological or physical dependence, empagliflozin doesn't create these effects. If you have concerns about medication dependence, you can feel confident that empagliflozin doesn't carry this risk while managing your health condition.
Is Apixaban safe for the elderly?
This medicine is safe and works just as well for older people (over 65) as it does for younger people. Many older adults were included in the studies testing this medicine. It's important not to stop taking this medicine suddenly, as that can increase the risk of blood clots. Talk to your doctor before you stop.
Is it safe to drink alcohol while taking Apixaban?
Drinking alcohol while taking Apixaban can increase the risk of bleeding and interfere with liver metabolism. Occasional light drinking may be acceptable, but heavy alcohol use should be avoided. Always consult your doctor to determine what’s safe for you.
Is it safe to exercise while taking Apixaban?
Yes, exercise is generally safe while taking Apixaban , but you should take precautions. Avoid high-impact or contact sports that increase the risk of injury and bleeding (e.g., football, boxing). Low-impact activities like walking, swimming, and yoga are safer options. Always consult your doctor before starting a new workout routine.
Is it safe to stop Apixaban?
Stopping empagliflozin suddenly can cause serious problems for your health conditions. If you're taking it for type 2 diabetes, your blood sugar levels might rise quickly when you stop. For heart failure, which is when your heart can't pump blood effectively, or kidney disease, which is damage to organs that filter waste from your blood, stopping could make these conditions worse. A dangerous complication called diabetic ketoacidosis might occur if you suddenly stop taking empagliflozin. This condition, which causes harmful acids to build up in your blood, can cause nausea, vomiting, stomach pain, and breathing problems. This risk continues for several days after stopping the medication. Always talk with your doctor before stopping empagliflozin. They might suggest gradually reducing your dose or switching to a different medication to keep your condition under control. Your doctor will help you make any medication changes safely to protect your health.
What are the most common side effects of Apixaban?
Side effects are unwanted reactions that can happen when taking a medication. With empagliflozin, these effects vary from person to person. The most common side effect is urinary tract infections, which affect about 8-9% of people taking this medication. Women may experience genital yeast infections, which occur in about 2-5% of female patients. Men can also get genital yeast infections, but this happens less frequently. Some people notice they urinate more often when taking empagliflozin, which happens in about 1-3% of patients. Upper respiratory infections, which affect your nose, throat, and airways, occur in about 4% of people taking this medication. If you notice new symptoms after starting empagliflozin, they might be temporary or unrelated to the medication. Talk with your doctor before stopping any medication.
Who should avoid taking Apixaban?
**Important Warnings:** * **Allergic reactions:** If you have chest pain, swelling of your face or tongue, trouble breathing, or feel dizzy, call your doctor or get help right away. * **Tell your doctor about other medicines you take:** Some medicines can affect how this medicine works or increase your risk of bleeding. * **Swallowing the tablet:** If you can't swallow it whole, talk to your doctor about other ways to take it. * **Don't stop taking this medicine:** Stopping it may increase your risk of stroke. * **Refill your prescription:** Don't run out of this medicine. * **Overdose:** Call your doctor or go to the hospital if you take too much. * **Head injuries:** Call your doctor if you fall or injure your head, especially if you hit your head. * **Bleeding risk:** You may have a higher risk of bleeding if you take other medicines that increase bleeding risk. * **Spinal anesthesia:** If you have spinal anesthesia, your doctor should watch you for bleeding or blood clots.
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