Apixaban

Medication Information Leaflets

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What is this medication for?

Apixaban is a blood thinning medication that prevents blood clots from forming in your body. It does not remove clots that are already formed, but prevents these clots from becoming bigger. 

You may be given Apixaban for:
  • Treatment or prevention of Deep Vein Thrombosis (blood clot in the legs) or Pulmonary Embolism (blood clot in the lungs)
  • Prevention of stroke in Atrial Fibrillation, a condition where there is irregular heart rhythm
  • Prevention of blood clot formation after a hip or knee replacement operation
The length of treatment may range from a few weeks to long term.

How should I take this medication?

  • Do not stop taking your medication without checking with your healthcare professional.
  • This medication should be taken two times a day.
  • You may take this medication with or without food. 
  • If you are unable to swallow the tablets whole, you may crush the tablets and mix with water immediately before taking it.

What should I do if I forget to take this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses at a time to make up for the missed dose.

What precautions should I take?

  • Inform your healthcare professional if you are allergic to this medication or any of the other ingredients of this medication.
  • There is no need to make drastic changes to your lifestyle. However, avoid sports or activities that may cause you to get injured. 
  • See a doctor if you have any fall or injury to any part of your body.
  • Inform all doctors, dentists and pharmacists that you are on Apixaban. There may be a need to stop the medication for a short period of time if you are going for a surgery or medical procedures such as an endoscopy or dental treatment. 
  • Inform your healthcare professional if you are pregnant, planning to become pregnant or breastfeeding.

What are some common side-effects of this medication?

  • You may experience stomach discomfort such as stomach pain, nausea or vomiting.
    • Take your medication after food to minimize these symptoms
    • Inform your healthcare professional if these symptoms do not go away
  • You may experience other forms of bleeding such as gum bleed when brushing teeth, unexplained nose bleed, or get bruises more easily. 
    • See a doctor if bleeding does not stop within minutes or if you feel unwell.
    • Use a soft toothbrush and floss your teeth gently.
    • Use an electric shaver instead of a blade.
    • For women, it is common to have increased menstrual flow but check with your doctor if you feel unwell.

What are some rare but serious side-effects that I need to seek medical advice for immediately?

  • See a doctor immediately or go to the hospital if you have any of the following symptoms that may indicate internal bleeding, such as:
    • Black, sticky, or bloody stools
    • Coughing up blood or brown material
    • Unexplained bruises or purple areas on skin
    • Blood in urine
    • Severe headache that does not go away
    • Sudden giddiness or confusion
    • Sudden stomach pain
    • Sudden backache or joint pain
    • Shortness of breath
  • If you experience any one or more of the drug allergy symptoms below, you should stop your medication and see your healthcare professional immediately: 
    • Swollen face/eyes/lips/tongue
    • Difficulty in breathing
    • Itchy skin rashes over your whole body
  • Blood clots may still form while you are taking Apixaban. The signs and symptoms depend on the site where they are found. See a doctor immediately or go to the hospital if you experience:
    • Symptoms of deep vein thrombosis such as leg swelling, redness, pain, warmth, numbness 
    • Symptoms of pulmonary embolism such as chest pain, shortness of breath, coughing up blood 
    • Symptoms of stroke such as muscle weakness, difficulty talking, blackouts, giddiness, blurred vision

What food or medication should I avoid when I take this medication?

Consult your healthcare professional before you take any other medication (either prescription or over-the-counter), nutritional supplements or herbal remedies. Some of these medications or supplements can affect the way Apixaban works.

Examples of medications or supplements that may affect Apixaban:

  • Antibiotics for tuberculosis (e.g. Rifampicin)
  • Medications to treat fungal infections (e.g. Itraconazole)
  • Seizure medications (e.g. Carbamazepine, Phenytoin)
  • St John's Wort

How should I store this medication?

Store the medicine in a cool, dry place away from heat, moisture and direct sunlight. Keep this medication away from children. 

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.


Disclaimers
If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.


This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore.

Last reviewed on August 2019
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Apixaban

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