Apixaban

What apixaban is and how it works

Apixaban is a prescription-only blood thinner (anticoagulant) that reduces the risk of dangerous blood clots by blocking a clotting factor called Factor Xa. It is taken as a tablet, usually twice a day. (1)

Take apixaban exactly as your prescriber directs, and do not stop taking it without talking to your prescriber first, even briefly -- stopping early raises your risk of a blood clot. Your exact dose and schedule depend on why you are taking it and your individual risk factors.

Mechanism of action: how apixaban works

Apixaban is a direct, reversible, highly selective inhibitor of Factor Xa, both free and clot-bound, which reduces thrombin generation and thrombus formation without requiring antithrombin as a mediator. (1)

What apixaban is used for

Before taking apixaban

Do not take / not appropriate for

• Do not take apixaban if you have active, clinically significant bleeding. (all countries) (1) (2)
• Do not take apixaban if you have had a severe allergic reaction to it or any of its ingredients. (all countries) (1) (2)
• Do not take apixaban if you have liver disease associated with a bleeding tendency (coagulopathy), or certain other conditions with a significant bleeding risk, such as active stomach ulcers or bleeding in the brain -- your prescriber will check for these before starting treatment. (all countries) (2)

Tell your clinician about

• Any history of bleeding problems, stomach ulcers, or bleeding in the brain.
• Any liver or kidney problems.
• If you have a mechanical heart valve, since apixaban is not recommended in this situation.
• All other medicines you take, especially other blood thinners, aspirin, or anti-inflammatory painkillers.
• Any upcoming surgery, dental work, or planned spinal/epidural procedures.
• Pregnancy, plans for pregnancy, or breastfeeding.

How to take apixaban

• Take by mouth, with or without food, at evenly spaced times (usually twice daily, about 12 hours apart).
• Swallow tablets whole with water; if you cannot swallow whole tablets, ask your pharmacist about crushing them and mixing with water or certain foods immediately before taking.
• Do not stop taking apixaban without talking to your prescriber first, even if you feel well -- stopping early raises the risk of a blood clot.
• Tell every healthcare professional you see, including dentists, that you take apixaban, especially before any surgery or procedure.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

Take the missed dose as soon as you remember on the same day, then continue with your normal twice-daily schedule. Do not take a double dose to make up for a missed one. Contact your prescriber if you are unsure.

Overdose

Seek urgent medical attention if you think you have taken too much apixaban, or if you notice signs of bleeding such as unusual bruising, blood in urine or stool, or prolonged bleeding from a cut. A specific reversal treatment is available in hospital settings for adults with serious or life-threatening bleeding. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Certain strong antifungal or antiviral medicines that block both P-glycoprotein and CYP3A4 (such as ketoconazole, itraconazole, or ritonavir) can significantly raise apixaban levels -- your prescriber may reduce your dose or avoid this combination. (1) (2)
• Certain medicines that strongly induce the same pathways (such as rifampicin, carbamazepine, phenytoin, or St. John's Wort) can lower apixaban levels and are generally avoided. (1) (2)
• Other medicines that increase bleeding risk, such as aspirin, other antiplatelet medicines, or anti-inflammatory painkillers, can add to apixaban's bleeding risk when combined. (2)
• Other anticoagulant medicines are generally not combined with apixaban, except during a carefully managed switch from one to the other. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Kidney function
• Liver function
• Full blood count / baseline bleeding risk assessment
• Body weight (used in dose-reduction criteria)

During treatment

• Watching for any signs of unusual bruising or bleeding.
• Periodic kidney and liver function checks, particularly if function is already reduced.
• Review before any planned surgery, dental work, or spinal/epidural procedure -- timing of stopping and restarting is individually planned by your prescriber.

Storage

Store at room temperature, in the original packaging, away from moisture. Check the specific product label for exact temperature range and expiry date.

Frequently asked questions

References

1. ELIQUIS (apixaban) tablets -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Bristol-Myers Squibb Company · United States · accessed 2026-07-29 · source 1
2. Eliquis 5 mg film-coated tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Bristol-Myers Squibb/Pfizer · United Kingdom · accessed 2026-07-29 · source 2
3. Eliquis (apixaban) -- European Public Assessment Report (EPAR) summaryEuropean Medicines Agency (EMA) · European Union · accessed 2026-07-29 · source 3
4. PrELIQUIS (apixaban) Product MonographHealth Canada product monograph · Canada · accessed 2026-07-29 · source 4
5. ELIQUIS apixaban 5 mg film-coated tablet -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 5
6. Eliquis New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-29 · source 6

Brand names by country

Single-ingredient apixaban names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries