Apixaban

This page gives a quick overview of the drug apixaban, including what it's used for, how to take it, how it works, common brand names with their strengths, important warnings, and possible side effects.

Context and Approval Date

Apixaban is a blood thinner that helps prevent clots. It belongs to a group of medicines called Factor Xa inhibitors and was approved for use on December 28, 2012.

Mechanism of Action of Apixaban

Apixaban is a direct inhibitor of factor Xa. It works by entering cells after being activated by the liver, where it interferes with DNA production. This disrupts the normal cell cycle, stopping cancer cells from growing and multiplying.

All Substitutes

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Product Packaging Size Manufacturer Price
Apiban 5mg Tablet 10 tablet MSN Laboratories INR 153
Prepixa 5mg Tablet 10 tablet Emcure Pharmaceuticals INR 178
Apigat 5mg Tablet 30 tablet Natco Pharma INR 550
Eliquis 5mg Tablet 10 tablet Pfizer Ltd INR 460

Uses of Apixaban

Apixaban is a type of direct oral anticoagulant (DOAC) developed to help prevent strokes and blood clots in people with conditions like atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).

Apixaban administration guidelines and available dosage options

Your doctor will decide the right dose and how long you need to take Apixaban based on your condition. Always follow their instructions.
The usual starting dose is 2.5 mg twice a day. Take the tablet at the same time each day, with or without food. Swallow it whole with water don’t chew, crush, or break it.
If you miss a dose, just take the next one at your regular time. Do not take two doses at once to make up for a missed dose.

Information about Apixaban

Apixaban is used to prevent strokes, deep vein thrombosis (DVT), and pulmonary embolism (PE). It helps stop blood clots from forming in the legs, lungs, brain, or heart.

How Apixaban works

Apixaban is a newer type of blood thinner (called a NOAC). It works by stopping blood clots from forming in the body.

Common side effects of Apixaban

  • Anemia (low red blood cells)
  • Blood in urine
  • Bruising
  • Nausea
  • Nosebleeds
  • Hematoma (a collection of blood outside blood vessels)
  • Apixaban is an effective medicine for preventing blood clots.
  • You can take Apixaban with or without food, but it’s better not to take it at night.
  • Apixaban has fewer interactions with food and other medicines, so you usually don’t need to change the dose often.
  • Apixaban can increase your risk of bleeding. Be careful when shaving, cutting nails, using sharp objects, or playing contact sports like football or wrestling.
  • If you need surgery or dental treatment, your doctor might ask you to stop taking Apixaban for a short time.
  • Tell your doctor right away if you notice blood in your vomit, urine, or stool (such as black, tarry stools or bright red blood).
  • Let your doctor know if you have any kidney problems.
  • Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
  • Don’t stop taking this medicine without talking to your doctor first.

    • Warning, Precautions, and Side Effects Associated with Apixaban

    Warning

    This medicine can interact with other blood thinners and may increase the risk of a serious condition called spinal or epidural hematoma (a blood clot near the spine), especially if you have a spinal procedure or receive spinal anesthesia.
    That’s why it’s important to tell your doctor if you’re planning any medical or dental procedures, including surgery. This helps them take the right precautions.
    Doctors should closely watch for signs of nerve problems, such as numbness or tingling in the arms or legs, weakness, or loss of control over your bladder or bowels. If any of these symptoms appear, get medical help immediately to prevent permanent nerve damage.
    During your treatment, your doctor may also check your blood counts, clotting levels (like PT and INR), blood sugar, electrolytes, liver, and kidney function to avoid serious side effects.

    Precautions

    This medicine is not recommended during pregnancy because it may harm the unborn baby. Let your doctor know if you are pregnant or planning to become pregnant before starting treatment.
    It’s not clear whether this drug passes into breast milk, so talk to your doctor before breastfeeding. This medicine should not be used in people with liver disease that affects blood clotting or causes a high risk of bleeding. It’s also not recommended for those with severe liver problems.
    Some versions of this medicine may contain lactose, which can cause bloating and stomach pain in people who are lactose intolerant. If you have trouble digesting lactose, inform your doctor before starting treatment.

    Side Effects

    Common side effects of Apixaban may include fainting, low blood pressure, skin rash, hair loss, itching, and a low platelet count. If you notice any allergic or unusual reactions after taking this medicine, contact your doctor right away.

    Word Of Advice

    Apixaban can increase the risk of bruising, so be extra careful when using sharp objects or doing activities that might cause injury.
    Always inform your doctor before having any medical or dental procedures so they can take the right precautions.
    Also, let your doctor know about any other medications you're taking, including over-the-counter drugs, supplements, or herbal products.
    Try to eat a consistent amount of high-fiber foods like fruits, vegetables, and whole grains. This can help prevent constipation, which may lower the risk of bleeding.

    FAQ - Apixaban

    1What is the purpose of the Apixaban tablet?
    The purpose of Apixaban tablet is to prevent and treat blood clots. It helps reduce the risk of serious problems like stroke, heart attack, and clots in the legs, lungs, or heart by thinning the blood and stopping clots from forming.
    2What foods to avoid when taking Apixaban tablet?
    When taking Apixaban tablet, there are no specific foods you must avoid. Unlike some blood thinners, Apixaban does not have major food interactions, so you can eat a normal, balanced diet.
    However, it’s best to:
  • Avoid excessive alcohol, as it can increase bleeding risk.
  • Maintain a healthy diet to support overall heart and blood vessel health.

    • If you have any special diet or other health conditions, talk to your doctor or pharmacist for personalized advice.
    3What should I avoid while taking Apixaban tablet?
    While taking Apixaban tablet, you should avoid:
    1. Skipping doses or stopping the medicine without talking to your doctor.
    2. Taking other blood thinners or NSAIDs (like aspirin, ibuprofen) unless your doctor approves, as they can increase bleeding risk.
    3. Drinking too much alcohol, which can raise the chance of bleeding.
    4. Activities with a high risk of injury or bleeding (like contact sports) to avoid cuts or bruises.
    5. Using herbal supplements or medicines without checking with your doctor, as some can affect how Apixaban works.
    Always follow your doctor’s advice and report any unusual bleeding or bruising right away.
    4What is the most common risk of Apixaban tablet therapy?
    The most common risk of taking Apixaban tablet is bleeding. Since it thins the blood to prevent clots, it can also make it easier to bleed or bruise, even from minor injuries. If you notice unusual bleeding—like heavy nosebleeds, blood in urine or stools, or bruises that appear without a reason—you should contact your doctor immediately.
    5How does the Apixaban tablet work?
    Apixaban tablet works by blocking a protein in your blood called Factor Xa. This protein helps your blood clot. By stopping Factor Xa, Apixaban slows down the clotting process, which helps prevent harmful blood clots from forming in your veins or arteries. This reduces the risk of stroke, heart attack, and other problems caused by blood clots.
    6Is there any special diet that I should follow while taking Apixaban tablet?
    There is no special diet you need to follow while taking Apixaban tablet. Unlike some blood thinners, Apixaban doesn’t require you to avoid certain foods like leafy greens.
    However, it’s good to:
  • Eat a balanced, healthy diet to support your heart and blood vessels.
  • Limit alcohol because drinking too much can increase your risk of bleeding.
    • Always check with your doctor if you have any specific diet concerns or other health conditions.
    7Apixaban generic

    Apixaban generic

    Apixaban is a generic medicine manufactured by several top companies under different brand names, including:
    1. Natco Pharma – brand name Apigat Tablet
    2. MSN Laboratories – brand name Apiban Tablet
    3. Emcure Pharmaceuticals – brand name Prepixa Tablet
    4. Glenmark Pharmaceuticals – brand name Paxiba Tablet
    5. Pfizer Ltd – brand name Eliquis Tablet
    8Apixaban brand name​

    Apixaban brand name​

    1. Natco Pharma – brand name Apigat Tablet
    2. MSN Laboratories – brand name Apiban Tablet
    3. Emcure Pharmaceuticals – brand name Prepixa Tablet
    4. Glenmark Pharmaceuticals – brand name Paxiba Tablet
    5. Pfizer Ltd – brand name Eliquis Tablet
    9Apixaban side effects​

    Apixaban side effects​

    Common Side Effects of Apixaban (Apigat):
  • Bleeding (e.g., nosebleeds, bleeding gums, bruising easily)
  • Minor cuts that take longer to stop bleeding
  • Nausea
  • Anemia (low red blood cells) causing tiredness or weakness

    • Serious Side Effects (Seek medical help immediately):
  • Heavy or uncontrollable bleeding
  • Blood in urine or stools (which may look red or black)
  • Severe headache, dizziness, or weakness (signs of stroke or bleeding in the brain)
  • Unusual bruising or bleeding without injury
  • Allergic reactions like rash, itching, swelling, or difficulty breathing

    • If you experience any side effects, especially bleeding, contact your doctor right away.
    10Apixaban MOA

    Apixaban MOA (Mechanism of Action)

    Apixaban works by directly blocking Factor Xa, an important protein in the blood clotting process. Factor Xa helps convert prothrombin into thrombin, which then helps form blood clots. By inhibiting Factor Xa, Apixaban reduces thrombin production, which prevents blood clots from forming and growing. This helps lower the risk of stroke, heart attack, and other clot-related problems.

    References

  • Highlights of prescribing information; food and drug administration. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/211964s000lbl.pdf [Accessed on 03/Apr/2023].
  • Bristol Myers Squibb/Pfizer EEIG; Electronic Medicines Compendium; [Revised:2021] [Accessed on 03/Apr/2023] https://www.medicines.org.uk/emc/files/pil.4756.pdf
  • Annex I summary of Product Characteristics - European Medicines Agency; Available at: https://www.ema.europa.eu/en/documents/product-information/eliquis-epar-product-information_en.pdf
  • Katherine Victoria Hurst, John Matthew O’Callaghan and Ashok Handa; ; Quick reference guide to Apixaban; Published 2017 [Accessed on 03/Apr/2023] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513886/#__ffn_sectitle
  • SL Greig; Apixaban: A review in venous thromboembolism; [Published:2016] [Accessed on 03/Apr/2023]https://pubmed.ncbi.nlm.nih.gov/27653758/
  • Goodman & Gilman’s, The Pharmacological Basis of Therapeutics,Modulation of Cardiovascular Function, 12th edition, 2011, 867.
  • Bertram.G.Katzung, Basic and Clinical Pharmacology, Drugs Used to Treat Diseases of the Blood, Inflammation, & Gout, 14th edition, 617.