Apixaban: what it is and why people take it

Apixaban (brand name Eliquis) is an oral anticoagulant that blocks factor Xa. In simple terms: it thins blood to lower the chance of clots. Doctors commonly prescribe it to prevent stroke in atrial fibrillation, treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), and for some surgery-related clot prevention.

Big clinical trials showed real benefits. In the ARISTOTLE trial, apixaban lowered the risk of stroke or systemic embolism and caused less major bleeding than warfarin. The AMPLIFY trial found it works well for treating VTE and causes less bleeding than older regimens.

Practical dosing rules you can use

Typical dosing depends on why you’re taking it. For atrial fibrillation the usual dose is 5 mg twice daily. Lower the dose to 2.5 mg twice daily if a person meets at least two of these: age 80 or older, body weight 60 kg (132 lb) or less, or serum creatinine 1.5 mg/dL or higher.

For initial treatment of DVT/PE the common schedule is 10 mg twice daily for the first 7 days, then 5 mg twice daily after that. Long-term prevention usually stays at 5 mg twice daily unless your doctor chooses an alternate plan.

Safety, interactions, and what to watch for

Bleeding is the main risk. That shows up as unusual bruising, bloody urine or stools, nosebleeds that won’t stop, or severe headaches. If heavy bleeding happens, seek emergency care immediately.

Apixaban interacts with strong CYP3A4 and P-gp inhibitors (for example, ketoconazole, ritonavir) which can raise drug levels, and strong inducers (rifampin, carbamazepine) which can lower them. Combining apixaban with other blood thinners or multiple antiplatelet drugs increases bleeding risk.

No routine INR checks are needed. There are lab tests (anti-Xa) that can measure effect in special cases, but they aren’t used for day-to-day care. If you miss a dose, take it the same day as soon as you remember; don’t double up.

Planning a procedure? Tell your surgeon or dentist you’re on apixaban. Typical advice is to stop the drug 24–48 hours before the procedure depending on bleeding risk and kidney function. Always follow the exact instructions from your prescribing clinician.

Reversal options exist. Andexanet alfa is an approved antidote for major bleeding caused by factor Xa inhibitors in some regions; prothrombin complex concentrate (PCC) is another emergency option when the antidote isn’t available. Your hospital will choose the right approach.

Got a question about apixaban and your health? Talk with your doctor or pharmacist. This guide is practical info, not a prescription. If you experience severe bleeding or sudden symptoms, get emergency care right away.