Apixaban brands and prices in Pakistan

About Apixaban

Apixaban is an anticoagulant, often called a blood thinner. It blocks a protein called factor Xa that the body needs to make clots, so it helps stop harmful clots forming. It does not break down clots that already exist. It is a prescription-only medicine and comes as tablets.

Who should not take it, or should take care

• Do not take it if you have had a serious allergic reaction to apixaban or any of its ingredients.
• Do not take it if you are bleeding heavily, or have a condition that makes serious bleeding likely, such as a recent or active stomach or bowel ulcer or a recent bleed in the brain.
• Not suitable for people with liver disease that raises the risk of bleeding.
• Tell your doctor if you have kidney disease or are on dialysis, other liver problems, a bleeding disorder, very high blood pressure that is not controlled, or an artificial heart valve.
• Tell your doctor if you have antiphospholipid syndrome, as treatment may need to change.
• Bleeding risk is higher in older people and in people with a low body weight. Your doctor will take this into account.
• Tell your surgeon, dentist and anyone treating you that you take it. You may need to pause it before an operation or procedure, but only stop when a doctor tells you.
• Pregnancy: NHS says it is not used in pregnancy, and the UK and Irish leaflets say not to take it if pregnant. Tell your doctor straight away if you become pregnant, and ask for advice first if you are planning a pregnancy.
• Breastfeeding: NHS says it should not be used while breastfeeding. The leaflets say it is not known whether it passes into breast milk, so ask your doctor.
• Children: sources differ on age and weight limits (NHS says it may be prescribed for some children; one leaflet says not recommended under 18). A specialist decides.

Medicines and drinks that can interact

• Other blood thinners such as warfarin, rivaroxaban, dabigatran, heparin and enoxaparin
• Aspirin and anti-inflammatory painkillers (NSAIDs) such as ibuprofen and naproxen, which raise the risk of bleeding. Do not start them without asking.
• Antiplatelet medicines such as clopidogrel
• Some antifungal medicines (for example ketoconazole)
• Some HIV medicines (for example ritonavir)
• Some heart and blood pressure medicines, such as diltiazem
• Antidepressants of the SSRI and SNRI types, which can raise the risk of bleeding
• Epilepsy medicines such as phenytoin, and some antibiotics for infections such as rifampicin, which can make apixaban work less well
• St John's wort, which can make apixaban work less well
• Tell your doctor or pharmacist about all medicines, supplements and herbal remedies, and tell emergency staff you take apixaban, because some stroke treatments can interact.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor or pharmacist tells you, and do not stop it unless a doctor advises you to. Stopping can raise your risk of clots and, if you have atrial fibrillation, of stroke.
• Carry the anticoagulant alert card you are given at all times and show it to doctors, dentists and pharmacists before any treatment or procedure.
• You can eat and drink as normal while taking it.
• If you miss a dose, leaflets say to take it as soon as you remember, but the advice differs depending on how your medicine is taken. Never take a double dose. If unsure, ask your pharmacist or read your leaflet.
• Refill your prescription before you run out.
• Keep a list of your medicines with you.
• Check with a pharmacist before buying painkillers, supplements or herbal remedies.
• Store it out of the reach of children, and return unwanted medicine to a pharmacy rather than flushing it away.

Common questions

Can I drink alcohol while taking apixaban?
An NHS hospital leaflet says moderate drinking is allowed, but heavy or binge drinking increases the effect of the medicine and your bleeding risk.

What should I do if I hit my head?
Go to the emergency department even if you feel fine, and tell staff you take apixaban. Do not drive yourself.

Do I need to avoid certain foods?
No. NHS says you can eat and drink as normal while taking apixaban.

Can I take ibuprofen or aspirin for pain?
Not without asking first. They can raise the chance of bleeding when taken with apixaban. Ask a pharmacist or doctor which pain reliever is safer for you.

What if I need an operation or dental work?
Tell the surgeon or dentist. They may ask you to pause the medicine for a while and will tell you when to start again. Do not stop it yourself.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.