What is Eliquis^® (apixaban)?

What is Eliquis® (apixaban) used for?

Eliquis^® (apixaban) is an oral medication prescribed to reduce the risk of blood clotting and stroke. People with atrial fibrillation (a type of irregular heartbeat) are at an increased risk of forming a blood clot in the heart, which can travel to the brain, causing a stroke, or to other parts of the body. Eliquis^® lowers your chance of having a stroke by helping to prevent clots from forming. Eliquis^® is also used to reduce the risk of forming a blood clot in the legs and lungs of those who have just had hip or knee replacement surgery. Eliquis can be used to treat blood clots in the veins of your legs or lungs, and reduce the risk of them occurring again.

What are the side effects of Eliquis^®?

While taking Eliquis^® you may bruise more easily and it may take longer for bleeding to stop. You should call your doctor or seek medical help if you have unusual bleeding from the gums, frequent nosebleeds, menstrual bleeding that is heavier than normal, pink or brown urine, or red or black stools that resemble tar. You should also seek medical attention if you cough up or vomit blood, have unexpected joint pain or swelling, have severe headaches, or feel dizzy.

What foods should I avoid while taking Eliquis^®?

You can take Eliquis^® (apixaban) with or without most foods. You should avoid grapefruit, grapefruit juice, marmalades, limes, and pomelos while you are taking Eliquis^®. These fruits prevent the breakdown of apixaban and may increase side effects.

Can I drink alcohol while on Eliquis^®?

Alcohol may increase the risk of bleeding in your stomach and intestines by irritating the tissue. Alcohol may itself act as a blood thinner after just one or two drinks, by decreasing platelet clumping. If you drink too much alcohol, it may affect your balance. You are more likely to bleed internally after falling down while taking a blood thinner like Eliquis^®. Finally, your risk of developing a blood clot increases after consuming more than two servings of alcohol per day. The American Blood Clot Association recommends that anyone with a clotting disorder should use extreme caution when drinking. It is best to avoid alcohol while taking Eliquis^®, but an occasional small drink is probably safe.

Is there a reversal agent for Eliquis^®?

The reversal agents for Eliquis^® (apixaban) are Andexxa^® (andexanet alfa) and KCentra^® (prothrombin complex concentrate). Either can be used to reverse the effects of Eliquis^®. They are given intravenously in a hospital and are used only when Eliquis® causes life-threatening or uncontrolled bleeding.

What is apixaban’s mechanism of action?

Eliquis^® (apixaban) is a direct factor Xa inhibitor that will binds to and inactivates factor Xa. Factor Xa plays a crucial role in the blood clotting mechanism when you get an injury by forming a mesh. Your blood is less likely to clot while taking Eliquis^®.

How is Eliquis® different from other blood thinners? 

Eliquis^® (apixaban) belongs to a group of medications referred to as anticoagulants. This group also includes heparin, Coumadin^® (warfarin), Xarelto^® (rivaroxaban), and Pradaxa^® (dagibatran). They all slow clot formation in the body.

Another similar class of drugs includes the antiplatelet agents, Plavix^® (clopidogrel), Effient^® (prasugrel), Brillinta^® (ticagrelor), and aspirin. They prevent platelets in the blood from clumping into a clot.

Eliquis^® binds to a protein called Factor Xa, which stops it from building clots. Warfarin inhibits the protein that activates Vitamin K. Vitamin K is needed to make clots.

Patients on Eliquis^® (apixaban) don’t need to be as closely monitored as patients taking warfarin.

Is Eliquis^® safe to take during pregnancy?

There are few studies about the safety of Eliquis^® (apixaban) while pregnant. It is not recommended in pregnancy. Patients should be switched to a different medication if pregnant or planning to become pregnant.

What are some Eliquis^® overdose symptoms?

Eliquis^® (apixaban) can increase the risk of bleeding after overdose, but this could take a few hours to become noticeable. Signs of excessive bleeding that are serious include passing blood in the urine or stool, severe bruising, nosebleeds that last more than 10 minutes, vomiting or coughing up blood, or sudden severe back pain.

What should you do if you take too much Eliquis^®, or if someone takes Eliquis^® who should not?

If you experience unexpected symptoms after taking Eliquis^® (apixaban) or take too much, get guidance from Poison Control immediately. Poison control help is available online at poison.org and by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.

Elizabeth Estrada, BS, PharmD Candidate 2023
Student Pharmacist