Eliquis (apixaban) is a common anticoagulant medication used to treat and prevent blood clots. It comes in 5 mg and 2.5 mg tablets. Some patients are prescribed lower 2.5 mg doses, leading to questions about whether the 5 mg tablets can be split in half.
This article provides comprehensive information about splitting Eliquis, including the risks, proper technique, safety measures, and expert opinions. While Eliquis tablets are technically “splittable,” there are precautions patients should take to ensure safe and effective use. Work closely with your healthcare provider to determine if splitting tablets is appropriate for your situation.
- Eliquis tablets can be split, but it’s best to check with your doctor first.
- Cutting Eliquis tablets destroys the protective coating.
- Take precautions like using a proper tablet cutter and swallowing halves immediately.
- Store split tablets very carefully in the original bottle to avoid moisture.
- Never split Eliquis tablets in advance or store halves for later.
- Splitting tablets could result in uneven doses if done improperly.
- Talk to your pharmacist if you have any concerns about splitting Eliquis.
What is Eliquis and How is it Used?
Eliquis is the brand name for the drug apixaban, which belongs to a class of anticoagulants known as factor Xa inhibitors. It works by blocking factor Xa, a protein involved in blood clot formation.
Eliquis is FDA-approved for:
- Preventing blood clots in patients who have undergone hip or knee replacement surgery. The usual dose is 2.5 mg taken twice daily.
- Treating and preventing recurrence of deep vein thrombosis (DVT) and pulmonary embolism (PE). The dose varies between 10 mg twice daily, 5 mg twice daily, and 2.5 mg twice daily depending on the condition.
- Preventing stroke and blood clots in patients with nonvalvular atrial fibrillation. The usual dose is 5 mg twice daily.
Eliquis comes in round, yellow, film-coated tablets in 5 mg and 2.5 mg strengths. The tablets are NOT scored, meaning there is no line down the middle to guide breaking them in half.
Why Would Someone Want to Split Eliquis Tablets?
There are several reasons why someone might want to split their Eliquis tablets:
- Doctor prescribed a lower dose. The standard dosing of Eliquis for atrial fibrillation and blood clot treatment/prevention is 5 mg twice daily. However, some patients require a reduced 2.5 mg twice daily dose. If they have extra 5 mg tablets on hand, splitting them could provide cost savings.
- Trouble swallowing pills. Eliquis tablets are approximately 9 mm in diameter. Some patients have difficulty swallowing pills of this size. Cutting them in half makes them easier to swallow.
- To save money. Brand name Eliquis is expensive, often >$400 for a one month supply. Splitting the higher strength tablets in half can reduce the cost for patients prescribed the lower 2.5 mg dose.
- Dose adjustments. Doctors may advise taking half tablets during the transition between different doses of Eliquis or when discontinuing the drug.
While the motivation to split tablets is understandable, there are important factors to consider before doing so.
Is It Safe to Split or Cut Eliquis Tablets?
The answer is yes, Eliquis tablets can safely be split as long as proper precautions are taken.
According to the FDA, Eliquis tablets are considered “splittable” under the right conditions. The drug manufacturer and other medical authorities also confirm that Eliquis can be divided in half if advised by a healthcare provider.
However, there are some risks involved:
- Uneven doses. Without scoring, it can be difficult to split tablets into perfectly equal halves. One half may contain slightly more or less medicine.
- Loss of tablet coating. Eliquis tablets have a film coating to protect the medicine, mask any bitterness, and make it easier to swallow. Cutting the tablet destroys this coating.
- Drug instability. Once split, the tablets lose their protective coating and are more susceptible to moisture. This can affect the drug’s potency if stored improperly.
While Eliquis can be split, precautions should be taken to mitigate these risks.
Precautions for Splitting Eliquis Safely
If you and your doctor decide that splitting Eliquis is appropriate for your situation, follow these precautions for safe use:
- Use a tablet splitter or sharp knife to cut the tablets. Avoid crumbling.
- Take both halves immediately after splitting to avoid instability issues.
- Store remaining half tightly sealed in original bottle with desiccant.
- Do not split tablets in advance for later use. Only split at time of dosing.
- Check with pharmacist if tablets look damaged, discolored, or cracked after splitting.
- Consult doctor or pharmacist if you have any concerns about dose accuracy.
- Monitor for side effects or changes in efficacy after splitting tablets.
- Do not chew, crush, dissolve, or further divide the split tablets. Swallow halves whole.
Adhering to these precautions will help ensure you are getting the full desired dose from split Eliquis tablets.
How to Split Eliquis Tablets
If splitting Eliquis, follow these step-by-step instructions:
- Eliquis tablet
- Tablet cutter or sharp knife
- Clean, dry surface
- Wash hands thoroughly with soap and water. Dry hands.
- Take one Eliquis tablet from the bottle.
- Place the tablet into the tablet cutter or on a clean cutting surface.
- Use the cutter or knife to carefully split the tablet into two equal halves.
- Visually inspect the halves to ensure the split appears relatively even.
- Swallow both halves immediately with water. Do not chew or crush.
- Tightly seal the bottle with any remaining tablets. Store safely.
- Rinse tablet cutter after use. Allow to dry completely.
Only split Eliquis at the time of dosing. Discard any unused split tablets after 24 hours. Never store split tablets for future use.
If you have trouble splitting the tablets evenly, consult your pharmacist or doctor about the best solution.
What Experts Say About Splitting Eliquis
Medical experts generally agree that Eliquis can be split but offer important warnings:
I certainly understand your concern about not wanting to waste the Eliquis 5mg tablets you have on hand. As mentioned above, you can split the Eliquis 5mg tablets in half to attain a dose of 2.5mg.
Since the tablets are film-coated, you’ll want to make sure you use a sharp razor or dedicated pill splitter to cut these tablets evenly in half. You can see in the image below that these tablets are not scored.
Also, it is important to note that crushed or split tablets should not be stored for later use, so don’t cut all the tablets at once.
The takeaway is that splitting Eliquis has potential downsides. Discuss with your doctor first, and if advised to split, take precautions to split properly and safely.
Frequently Asked Questions
Here are answers to some common questions about splitting Eliquis tablets:
Can I use a pill cutter to split Eliquis?
Yes, you can use a tablet cutter or sharp knife to split the tablets. Ensure the cutter blade is sharp to split cleanly without crumbling.
How should I store the leftover half of the split Eliquis tablet?
Leftover split tablet halves should be immediately placed back into the original bottle with desiccant and stored tightly sealed. Discard any unused split tablets after 24 hours.
Is it safe to swallow a split Eliquis tablet?
Yes, the FDA confirms that split Eliquis tablets can be safely swallowed. Just make sure to take both halves to get the full dose. Do not chew or crush the halves.
Can I dissolve a split Eliquis tablet in water or juice?
No. Once split, you should swallow the halves whole. Do not attempt to dissolve or mix split tablets in liquids. This can impact the dose and potency.
Will cutting Eliquis tablets affect how the drug works?
If split properly, the medication should still be equally effective. However, improper splitting technique may result in slightly uneven doses between halves.
The Bottom Line
While Eliquis tablets can be split in half, there are potential risks involved. Work closely with your doctor or pharmacist to see if splitting is appropriate for your situation. Use proper precautions when cutting the tablets to ensure safe and effective use. With the right technique, cutting Eliquis can be an effective way to achieve a lower dosage or reduce costs.