Apixaban: Practical Guide for Patients

Apixaban (brand name Eliquis) is a popular oral blood thinner used to prevent and treat dangerous clots. Doctors prescribe it for atrial fibrillation to lower stroke risk, for deep vein thrombosis (DVT), pulmonary embolism (PE), and after some joint surgeries. It’s taken by mouth and works by blocking a key step in the clotting process.

Most people take apixaban twice a day. For atrial fibrillation the common dose is 5 mg twice daily. A lower dose, 2.5 mg twice daily, is used if you are 80 or older, weigh 60 kg or less, or have higher creatinine levels. For initial DVT/PE treatment many regimens use 10 mg twice daily for 7 days, then 5 mg twice daily. Follow your prescriber’s directions exactly.

Safety, bleeding signs, and what to do

Bleeding is the main risk. Minor bleeding like bruises or nosebleeds can happen. More serious signs include blood in urine or stool, long nosebleeds, coughing or vomiting blood, severe headaches, dizziness, or sudden weakness. If you have major bleeding or symptoms of a stroke, call emergency services right away.

Hospitals can reverse apixaban if needed; the approved antidote is andexanet alfa, though availability varies. If the antidote isn’t on hand, doctors use other treatments to manage bleeding. Carry a medication card or wear a medical ID that says you take apixaban. Always tell ER staff and dentists that you are on a blood thinner.

Everyday use, interactions, and travel tips

Take apixaban at roughly the same times each day—many people choose morning and evening. You can take it with or without food. If you miss a dose, take it the same day when you remember; do not double up the next dose. Don’t stop apixaban suddenly unless your doctor tells you to—stopping raises your risk of clots.

Avoid or use caution with drugs that raise bleeding risk. Common ones are NSAIDs (ibuprofen, naproxen), certain antidepressants (SSRIs, SNRIs), and other blood thinners. Some strong antibiotics and antifungals can change apixaban levels. Always check with your prescriber or pharmacist before starting any new medicine, even herbal supplements like fish oil or ginkgo, which can add bleeding risk.

If you have kidney or liver disease, pregnancy, are breastfeeding, or are elderly, your doctor will review risks and dosing. Routine INR blood tests aren’t needed with apixaban, but periodic kidney and liver checks help keep therapy safe. Planning surgery or dental work? Your team will advise when to stop apixaban and when to restart based on bleeding and clotting risk.

When buying meds online, use reputable pharmacies and keep a valid prescription. If you notice leg swelling, sudden shortness of breath, chest pain, or other signs of clotting, get urgent care. Small changes and simple precautions make apixaban safer and more effective for most people.