Eliquisapixaban

What is Eliquis?

Eliquis is used to prevent stroke and blood clots in adults with non-valvular atrial fibrillation (an irregular heart rhythm). It is also used to treat and prevent deep vein thrombosis (DVT — blood clots in the legs) and pulmonary embolism (PE — blood clots in the lungs), and to prevent blood clots after hip or knee replacement surgery.

How Eliquis works

Apixaban directly blocks Factor Xa, a key protein in the blood clotting cascade. By blocking this factor, Eliquis reduces the formation of blood clots without needing to be adjusted as frequently as older blood thinners like warfarin. Unlike warfarin, it does not require routine INR blood tests and has fewer food interactions.

Forms and strengths

Tablets: 2.5 mg and 5 mg. For most indications, the 5 mg twice-daily dose is standard. Dose reduction to 2.5 mg twice daily applies in certain patients (age ≥80, weight ≤60 kg, or creatinine ≥133 micromol/L — must meet at least 2 of these 3 criteria, or for DVT/PE prevention after surgery).

How Eliquis is taken

Taken twice daily (every 12 hours), with or without food. For atrial fibrillation and DVT/PE treatment: typically 5 mg twice daily (or 2.5 mg twice daily if dose reduction criteria apply). For DVT/PE treatment, an initial higher dose of 10 mg twice daily for 7 days is used. Consistency is important — taking both doses approximately 12 hours apart. If you miss a dose, take it as soon as possible on the same day; do not double up.

This is general information, not a dose for you. Dosing depends on the reason you are taking it, your kidney and liver function, your age, and everything else you take — follow the directions on your own label, and ask us if they differ from what you read here.

If you miss a dose

Apixaban is short-acting, so a missed dose leaves you less protected. Take the missed dose as soon as you remember on the same day, then return to your usual twice-daily times. If you only remember when the next dose is due, take the single scheduled dose — do not take two at once to catch up. If you have missed more than one dose, call your pharmacist for advice rather than guessing.

Side effects

Common — usually manageable

Get medical help for these

• Major bleeding — severe headache, sudden vision changes, coughing or vomiting blood, blood in stool (black, tarry, or bright red stools), prolonged bleeding from cuts — seek emergency care immediately
• Intracranial hemorrhage (brain bleed) — sudden severe headache, weakness on one side, confusion, speech difficulty — call 911
• Spinal or epidural hematoma — if you receive a spinal injection or epidural anaesthesia while on Eliquis, blood can pool around the spinal cord, causing paralysis — report back pain, numbness, or weakness in legs
• Increased stroke risk on abrupt discontinuation — never stop without medical guidance

Important warnings

Who should take extra care

Active bleeding or a recent bleed

Anticoagulation may need to be paused or reconsidered — always physician-directed.

Upcoming surgery, dental work or procedures

Timing of any interruption is decided by your prescriber. Stopping without a plan raises clot risk.

Kidney or liver impairment

Doses may be reduced, and significant liver disease with coagulopathy is a contraindication.

Older adults and low body weight

Dose reduction criteria are based partly on age, weight and creatinine — worth confirming your dose is right for you.

NSAIDs and aspirin

Ibuprofen, naproxen, and aspirin all add to bleeding risk. Check before buying anything over the counter.

Mechanical heart valve

DOACs are not used with mechanical valves — warfarin is required.

Who should not take it

• Active bleeding (e.g., active GI bleed, intracranial hemorrhage)
• Severe liver disease (hepatic failure)
• Prosthetic heart valves — warfarin is required for this indication, not DOACs
• Antiphospholipid antibody syndrome (especially triple-positive APS) — warfarin preferred
• Allergy to apixaban

Drug interactions

Aspirin and NSAIDs (ibuprofen, naproxen, diclofenac) increase bleeding risk — avoid regular use; low-dose aspirin (81 mg) is sometimes used with Eliquis by cardiologists but with the understanding of increased bleeding risk. Strong CYP3A4 and P-gp inhibitors (ketoconazole, itraconazole, ritonavir) significantly increase apixaban levels — dose reduction or avoidance may be needed. Strong inducers (rifampin, carbamazepine, St. John's Wort, phenytoin) reduce apixaban levels and may make it less effective — avoid combinations. Dual antiplatelet therapy (aspirin + clopidogrel) with Eliquis carries very high bleeding risk.

Commonly asked about alongside Eliquis: Aspirin, Advil, Aleve.

This is not a complete list. If you take several medications, or buy anything over the counter, a pharmacist medication review is the reliable way to catch interactions that matter.

Coverage in British Columbia

Frequently asked questions

Related reading

Pill4Me Pharmacy is at 5625 Promontory Rd Unit 101, Chilliwack, BC. We deliver free to Chilliwack, Sardis, Promontory, Vedder and Yarrow, and you can reach a pharmacist directly at 604-705-3644.