Apixaban

Apixaban is a prescription medication used to reduce the risk of clot formation and prevent stroke in adults with non-valvular atrial fibrillation (AFib). It is also prescribed to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE), and reduce the risk of them recurring. Apixaban belongs to a class of direct oral anticoagulants that work by blocking Factor Xa, helping prevent the formation of harmful blood clots.

Although generic Apixaban received FDA approval in December 2019, its widespread availability has been delayed due to patent protections and market exclusivity for the brand-name medication. As these patent protections expire, generic Apixaban is expected to become more widely available in the U.S., offering a lower-cost option for patients who need long-term anticoagulation therapy.

Quick Facts About Apixaban

Apixaban and Eliquis are not exactly the same, but they contain the same active ingredient.

• Apixaban is the generic name of the drug
• Eliquis is the brand-name version

Both Apixaban and Eliquis work the same way in the body. They are Factor Xa inhibitors that reduce the risk of blood clots, stroke, deep vein thrombosis (DVT), and pulmonary embolism (PE). At present, Eliquis remains the most widely available version in the U.S. Although the FDA approved generic apixaban, market availability has been limited due to patent and exclusivity protections.

The appropriate dose varies based on the treated condition, patient age, body weight, and kidney function. Always follow your doctor’s instructions.

Apixaban Dosage for Stroke Prevention in AFib (Adults)

Apixaban Dosage for Treatment of DVT/PE (Adults)

Patients prescribed Apixaban for atrial fibrillation or DVT should follow these guidelines to ensure safe and effective use:

• Take tablets as prescribed by your physician, typically twice daily.
• You may take the medicine with or without food as instructed by your healthcare provider.
• Swallow the tablet whole with water.
• Do not skip doses. Missing doses can increase your risk of stroke or blood clots.
• If you miss a dose, take it as soon as you remember on the same day, then continue your regular schedule. Do not double the dose.
• Do not stop Apixaban suddenly, as it can increase the risk of blood clots.
• Tell your doctor before taking pain relievers like aspirin or NSAIDs, as these may raise bleeding risk.
• Avoid starting new medications, supplements, or herbal products without medical advice.
• Monitor signs of bleeding, such as unusual bruising, nosebleeds, blood in urine or stools, or bleeding from cuts that last longer.
• Store medicine at room temperature, away from moisture and heat.

Apixaban is a direct oral anticoagulant that selectively blocks Factor Xa. It is an essential enzyme in the blood clotting process. By inhibiting Factor Xa:

• Blood clot formation is reduced
• The chances of stroke and systemic embolism in patients with AFib are decreased
• Existing blood clots are prevented from growing larger

According to the FDA Prescribing Information for Eliquis (Apixaban), patients may experience the following adverse effects. These effects may vary from person to person.

Before you buy Apixaban online, be mindful of the following warnings and preventive measures:

Apixaban Black Box Warning

1. Sudden Discontinuation of Apixaban Tablets:

• Stopping Apixaban suddenly raises the risk of blood clots, stroke, or other serious problems.
• This risk is higher in people taking Apixaban for atrial fibrillation.
• If the discontinuation is necessary, tell your doctor. They may prescribe another anticoagulant to reduce the risk of clotting.

1. Risk of Spinal or Epidural Blood Clots (Hematoma)

• Patients receiving spinal anesthesia, epidural procedures, or spinal punctures while taking Apixaban may develop a spinal or epidural hematoma.
• These clots can lead to long-term or permanent paralysis if not treated quickly.
• The risk is higher if you:
  • Have an epidural catheter.
  • Take other medicines that increase bleeding risk, such as NSAIDs, aspirin, or other blood thinners.
  • Have a medical history of spinal surgery or spinal deformity.
• Get emergency medical help right away if you notice:
  • Back pain
  • Numbness or tingling
  • Muscle weakness
  • Loss of bladder or bowel control

What to Avoid When Taking Apixaban?

• Blood thinners and certain pain relievers like ibuprofen and naproxen, unless your doctor advises otherwise. This may increase bleeding risk.
• Herbal supplements that can affect bleeding, such as ginkgo biloba, garlic supplements, ginseng, and St. John’s wort.
• Activities with a high risk of injury, as even minor trauma may cause serious bleeding.
• Spinal or epidural procedures without informing your medical provider.
• Excessive alcohol use can increase bleeding risk and stomach irritation.

What Precautions Should Be Taken When Taking Apixaban?

• Before taking Apixaban for deep vein thrombosis or atrial fibrillation, tell your doctor if you have:
  • Kidney disease
  • History of bleeding problems
  • Liver issues
  • Other medical conditions
• This medication may increase the risk of bleeding during pregnancy and delivery. Pregnant patients should discuss risks and benefits with their doctor.
• It is unknown whether the drug passes into human breast milk. Breastfeeding is not advised while taking this blood thinner unless your doctor tells you otherwise.
• The safety and effectiveness of Apixaban in pediatric patients have not been established.
• Do not take Apixaban blood thinner if you have:
  • Prosthetic heart valves
  • Unstable pulmonary embolism (PE)
  • Active pathological bleeding
  • Triple-positive antiphospholipid syndrome
• Some women may experience increased or abnormal uterine bleeding while taking this medication.
• Bleeding risk while taking Apixaban blood thinner is higher in older patients due to age-related factors. Caution should be exercised in such populations.
• Taking too much Apixaban for deep vein thrombosis or atrial fibrillation may increase bleeding risk.
• This medication is not recommended in people with severe liver impairment and should be used cautiously in moderate liver disease.
• Dose adjustments may be required in patients with reduced kidney function, especially in AFib.

Atrial fibrillation (AFib) is a common irregular heartbeat condition that could increase the risk of stroke and other blood clots. For many years, warfarin was the standard anticoagulant used to reduce these risks. In more recent years, Apixaban (brand-name Eliquis), a DOAC, has become widely prescribed due to its lower risk of serious bleeding.

• In the ARISTOTLE clinical trial, Apixaban reduced stroke and systemic embolism more than warfarin in patients with AFib.
• The medication also caused less major bleeding than warfarin.
• Overall death rates were slightly lower with Apixaban than with warfarin.
• Patients taking apixaban do not require frequent INR blood tests, and it has fewer dietary and drug interactions.

Here are a few medications that should be avoided or used only with careful medical supervision:

High-Risk Interactions

• Other Anticoagulants:
  • Warfarin
  • Heparin
  • Enoxaparin
  • Dabigatran
  • Rivaroxaban
  • Edoxaban

Moderate-Risk Interactions (Use with Caution)

• Antiplatelet Agents
  • Aspirin
  • Clopidogrel
  • Prasugrel
  • Ticagrelor
• NSAIDs
  • Ibuprofen
  • Naproxen
  • Diclofenac
  • Indomethacin

Depending on the patient’s condition, kidney function, bleeding risk, and medical history, these alternatives should be used. It is best to speak with your doctor before switching your treatment option.

• Xarelto (Rivaroxaban)
• Savaysa (Edoxaban)
• Pradaxa (Dabigatran)
• Warfarin
• Lovenox (Enoxaparin)

Currently, there is no information available on Apixaban cost. However, the brand-name Eliquis costs about $606 for a 30-day supply. The table below compares the average U.S. retail cost to the international options available through Polar Bear Meds.

Apixaban Price & Savings Compared to U.S. Pharmacies

Many U.S. patients choose to order Apixaban from Canada due to significant cost savings compared to typical U.S. pharmacy prices. Canadian pharmacies often offer lower medication prices as a result of regulated drug pricing structures. When you buy Apixaban online from Polar Bear Meds, you may save up to 90% compared to U.S. retail pharmacy rates. Savings may vary depending on prescription strength, quantity, and availability, but ordering from Canada is a cost-effective option for eligible patients.

Apixaban Coupons Savings Programs

At Polar Bear Meds, we not only provide high-quality medications at affordable prices, but also offer discounts to customers for added savings.

• Use the Apixaban coupon code ‘WELCOMEPB10’ to receive 10% off your first order.
• Get a $20 credit for each verified referral.
• Price match guarantee on all medications.
• If you find an identical drug at a lower price at a verified Canadian online pharmacy, we will match that price.

FDA approval–Generic Apixaban

FDA Prescribing Information

PubMed: ARISTOTLE Trial Results

Eliquis (Apixaban) Tablets

NHS–Apixaban Side Effects