Apixaban

If you have atrial fibrillation (a condition where the heart beats irregularly and can lead to blood clots and stroke) and are taking apixaban to help prevent strokes or serious blood clots, you are at a higher risk of having a stroke after you stop taking this medication. Do not stop taking apixaban without talking to your doctor. Continue to take apixaban even if you feel well. Be sure to refill your prescription before you run out of medication so that you will not miss any doses of apixaban. If you need to stop taking apixaban, your doctor may prescribe another anticoagulant ('blood thinner') to help prevent blood clots and lower your risk of stroke.

If you have epidural or spinal anesthesia or a shot in your spine while taking a 'blood thinner' such as apixaban, you could get a blood clot near your spine that can cause paralysis. Tell your doctor if you have a tube in your spine, or if you have had spine problems, back surgery, or more than one spinal shot. Tell your doctor and pharmacist if you are taking any of the following: anagrelide; aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen ^® , indomethacin, ketoprofen, and naproxen; cilostazol; clopidogrel; dipyridamole; eptifibatide; heparin; prasugrel; ticagrelor; ticlopidine; tirofiban, and warfarin. Call your doctor immediately if you experience muscle weakness (especially in your legs and feet), numbness or tingling (especially in your legs), or trouble controlling your bladder or bowels.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with apixaban and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm ) or the manufacturer's website to obtain the Medication Guide.

Talk to your doctor about the risks of taking apixaban.

Uses
How to Use
Precautions
Side Effects
Storage/Disposal
More Information

Why is this medicine prescribed?

Apixaban is used to:

prevent strokes or blood clots in people who have atrial fibrillation (a condition where the heart beats irregularly and can lead to clots and stroke) in adults.
prevent deep vein thrombosis (DVT; a blood clot, usually in the leg) and pulmonary embolism (PE; a blood clot in the lung) in certain situations.
treat DVT and PE

Apixaban is in a class of medications called factor Xa inhibitors. It works by blocking a natural substance that helps blood clots to form.

Are there other uses for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Apixaban comes as a tablet to take by mouth. It also comes as a tablet and capsule to be mixed with water and given as a suspension to take by mouth. Take with or without food twice a day. Take apixaban at around the same times every day. Your doctor will tell you when to start apixaban and how long to take it based on the reason it is being used.

Take apixaban exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are unable to swallow the tablets, you can crush them and mix with water, apple juice, or applesauce. Swallow the mixture right after you prepare it. Apixaban can also be given in certain types of feeding tubes. Ask your doctor if you should place this medication in your feeding tube. Follow your doctor's directions carefully.

If you are receiving the tablet or capsule for suspension (liquid mixture), you will receive instructions on how to mix and give the medicine with your prescription. Read it carefully. Take the suspension within 2 hours of making. This suspension can be given in certain types of feeding tubes. Ask your doctor if you should take this medication in your feeding tube. Ask your doctor or pharmacist if you have any questions on how to give the suspension.

Continue to take apixaban even if you feel well. Do not stop taking apixaban without talking to your doctor. If you stop taking apixaban, your risk of a blood clot may increase.

What special precautions should I follow?

Before taking apixaban,

tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking apixaban. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
you should know the following nonprescription or herbal products may interact with apixaban: St. John's wort; aspirin; NSAIDs (such as ibuprofen and naproxen). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking apixaban. Do not start any of these medications while taking apixaban without discussing with your healthcare provider.
you should know that apixaban may interact with certain medications that may be used to treat you if you have a stroke or other medical emergency. In case of an emergency, you or a family member should tell the doctor or emergency room staff who treat you that you are taking apixaban.
tell your doctor if you have an artificial heart valve or if you have heavy bleeding that cannot be stopped. Your doctor will probably tell you not to take apixaban.
tell your doctor if you have or have ever had any type of bleeding problem, antiphospholipid syndrome (APS; a condition that causes blood clots), or kidney or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking apixaban, call your doctor.
Call your doctor right away if you fall or injure yourself, especially if you hit your head. Your doctor may need to check you.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking apixaban. Your doctor may tell you to stop taking apixaban before the surgery or procedure. If you need to stop taking apixaban because you are having surgery, your doctor may prescribe a different medication to prevent blood clots during this time. Your doctor will tell you when you should start taking apixaban again after your surgery. Follow these directions carefully.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

unusual bleeding or bruising
red, brown, or pink urine
red or black, tarry stools
coughing up or vomiting blood or material that looks like coffee grounds

What side effects can this medicine cause?

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

bleeding gums, nosebleeds
heavy vaginal bleeding
red, pink, or brown urine
red or black, tarry stools
coughing up or vomiting blood or material that looks like coffee grounds
swelling or joint pain
headache
vomiting
rash
chest pain or tightness
swelling of the face or tongue
trouble breathing, wheezing
feeling dizzy or faint

Apixaban helps stop blood clots, so it might take longer for bleeding to stop if you are cut or injured. This medication may also cause you to bruise or bleed more easily. Call your doctor right away if bleeding or bruising is unusual or severe, or bleeding cannot be stopped.

Apixaban may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information. Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

What other information should I know?

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

¶ This branded product is no longer on the market. Generic alternatives may be available.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS ^® Patient Medication Information™. © Copyright, 2025. The American Society of Health-System Pharmacists ^® , 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: October 15, 2025.