apixaban at a glance
Medicine class
Direct oral anticoagulant and selective factor Xa inhibitor.
Main safety concern
Bleeding, which can occasionally be serious or life-threatening.
Food
May be taken with or without food.
Routine testing
Regular INR testing is not required, but clinical review and blood tests remain important.
Alert card
Carry the anticoagulant alert card and show it before medical, dental or surgical procedures.
What is apixaban used for?
Apixaban is licensed to prevent or treat thromboembolic disease. The authorised population varies by formulation.
Prevention of stroke and systemic embolism in adults with non-valvular atrial fibrillation and relevant risk factors.
Treatment of deep-vein thrombosis and pulmonary embolism in adults, and prevention of recurrence.
Prevention of venous thromboembolism in adults after elective hip- or knee-replacement surgery.
The selected tablet product also covers treatment and prevention of recurrent venous thromboembolism in specified paediatric patients; clinicians should check age, weight and formulation criteria.
How does apixaban work?
Apixaban directly and reversibly blocks activated factor X, reducing thrombin generation and fibrin-clot formation without directly inhibiting platelets.
apixaban preparations and strengths
Oral suspension
Route: Oral
Strengths: 1 mg/1 mL, 1 mg/mL
Tablet
Route: Oral
Strengths: 2.5 mg, 5 mg
How to take apixaban
Take apixaban exactly as prescribed and avoid unplanned interruptions. Tablets may be swallowed with water, with or without food. Selected tablets may be crushed and mixed with water, glucose solution, apple juice or apple purée and given promptly. Shake oral suspension thoroughly and measure it with the supplied oral syringe; devices and excipients differ between brands.
Keep the anticoagulant alert card with you.
Tell doctors, dentists and pharmacists that you take apixaban.
Do not change between tablets and liquid products without confirmation from a prescriber or pharmacist.
apixaban side effects
Common or expected effects
- Bleeding or bruising more easily
- Nosebleeds or bleeding gums
- Heavier or longer menstrual bleeding
- Anaemia, which may cause tiredness or pallor
- Nausea
- Blood in the urine
- Rash
Get urgent medical advice
- Heavy, recurrent or uncontrolled bleeding
- Blood in stools, vomit or coughed-up sputum
- Sudden severe headache, confusion, weakness, speech difficulty or seizures
- Severe allergic reaction with facial or throat swelling or breathing difficulty
- Marked dizziness, fainting or other symptoms suggesting substantial blood loss
apixaban in pregnancy
Apixaban is generally avoided during pregnancy because human safety information is inadequate and fetal exposure is possible. Contact the prescribing team promptly if pregnant, planning pregnancy or becoming pregnant while taking it. Do not stop treatment without advice.
apixaban while breastfeeding
Apixaban is not recommended during breastfeeding because transfer into milk has been reported and effects on a breastfed infant are uncertain. A prescriber or specialist should review alternative anticoagulation if treatment is required.
apixaban interactions
Interactions can increase bleeding or make apixaban less effective. Check prescribed, over-the-counter and herbal products before use.
Other anticoagulants
Usually avoid concurrent treatment because bleeding risk rises, except during carefully managed switching or specific specialist situations.
Antiplatelets such as aspirin, clopidogrel or ticagrelor
Can increase bleeding risk and should only be combined when clinically justified and reviewed.
NSAIDs such as ibuprofen or naproxen
May increase bleeding; check with a pharmacist or prescriber before use.
Common questions about apixaban
Answers are fully visible for fast scanning and source review.
Why is apixaban called a blood thinner?
It does not literally thin blood. It blocks factor Xa, so the body generates less thrombin and forms clots less readily.
Can apixaban be taken with food?
Yes. It may be taken with or without food.
Can apixaban tablets be crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.