Apixaban (Eliquis): Uses, Dosing, and Safety Tips

Apixaban is a blood thinner many doctors pick for preventing strokes and treating blood clots. It belongs to a class called direct oral anticoagulants (DOACs) and is best known under the brand name Eliquis. People take it for atrial fibrillation (to lower stroke risk), for deep vein thrombosis (DVT) and pulmonary embolism (PE), and sometimes after hip or knee replacement surgery.

Dosing depends on why you take it. For atrial fibrillation the usual dose is 5 mg twice a day, lowered to 2.5 mg twice a day if you meet two of these: age 80 or older, body weight 60 kg or less, or serum creatinine 1.5 mg/dL or higher. For treating DVT or PE doctors often start with 10 mg twice daily for seven days, then 5 mg twice daily thereafter. If you have severe kidney disease or low body weight your doctor may change the dose.

Apixaban needs less blood testing than warfarin, but that doesn’t mean no monitoring. Your healthcare provider should check kidney function before starting and periodically after that. Watch for drug interactions: strong CYP3A4 or P‑gp inhibitors like ketoconazole or ritonavir raise apixaban levels, while inducers like rifampin can lower its effect. Combining apixaban with anti‑platelet drugs, NSAIDs, or other anticoagulants increases bleeding risk.

Bleeding is the main risk with apixaban. Know the warning signs: unusual bruising, blood in urine or stool, prolonged nosebleeds, coughing or vomiting blood, severe headache or dizziness, and heavy menstrual bleeding. If you have serious bleeding call emergency services immediately. There is a reversal agent called andexanet alfa that can reverse apixaban in life‑threatening bleeding; when that’s not available, hospitals may use prothrombin complex concentrate.

Missed doses should be handled simply: take the missed dose as soon as you remember the same day and go back to the normal schedule. Do not double doses to catch up. If you take a once‑daily dose for other drugs, follow that medication’s rules; apixaban is twice daily for most indications.

Before starting apixaban tell your doctor about all medicines you take, including over‑the‑counter pain relievers and herbal supplements like St. John’s wort. Also mention liver or kidney disease, recent surgeries, or active bleeding. If you are pregnant, planning pregnancy, or breastfeeding, discuss alternatives—anticoagulant choices differ in these situations.

If you need a procedure, your care team will tell you when to stop apixaban before the operation and when to restart it afterward. Never stop apixaban suddenly without medical advice, because doing so can raise the risk of clots.

Want to learn how apixaban compares to older drugs like warfarin or antiplatelet medicines like clopidogrel? Read our related guides on Coumadin, Plavix, and blood clots in stents for practical comparisons and safety tips. Always follow your prescriber’s advice and buy medicines from trusted pharmacies only.

Carry a medication card stating you take apixaban, tell dentists and ER staff before procedures, avoid heavy alcohol use, and ask your pharmacist about safe over‑the‑counter pain relievers. Small habits cut bleeding risk and keep your treatment effective.