Disclaimer: This article is for informational purposes only and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
Overview
Eliquis is the brand name of apixaban, a prescription anticoagulant (blood thinner). It makes it harder for blood to clot. It comes as 2.5 mg and 5 mg tablets, and generic apixaban is also sold in Canada.
Health Canada has authorized Eliquis for adults to lower the risk of stroke in atrial fibrillation (an irregular heartbeat), to treat deep vein thrombosis and pulmonary embolism and stop them from coming back, and to prevent blood clots after planned hip or knee replacement surgery. It is usually started after a diagnosis, and it needs follow-up.
Eliquis needs a prescription. BC residents can speak with a BC-licensed doctor by phone through Avee Health to ask whether it is appropriate for them. The doctor decides based on your health history. A prescription is not guaranteed. If you already take Eliquis, do not stop it without medical advice.
In Canada, Eliquis is authorized in adults for:
- Preventing stroke and clots elsewhere in the body in people with atrial fibrillation
- Treating deep vein thrombosis (DVT) and pulmonary embolism (PE), and preventing them from coming back
- Preventing blood clots in the veins after planned hip or knee replacement surgery
Eliquis is not authorized for children. These conditions need a diagnosis first, and the doctor may need blood tests, heart tests or an in-person assessment.
Apixaban
Anticoagulant (factor Xa inhibitor)
cardiovascular
Prescription required
Available
How Eliquis Works
Apixaban blocks factor Xa, a protein the body needs to form blood clots. With less clotting, clots are less likely to form in the heart or the veins, or to travel to the brain or lungs. The same effect means you can bleed more easily.
Dosage Instructions of Eliquis
Your doctor sets your dose. The usual doses in the Canadian product monograph are:
- Atrial fibrillation: 5 mg twice a day. The dose is 2.5 mg twice a day for people who have at least 2 of the following: age 80 or older, weight of 60 kg or less, or a high creatinine level (a sign of reduced kidney function).
- Treating DVT or PE: 10 mg twice a day for the first 7 days, then 5 mg twice a day.
- Preventing another DVT or PE, after at least 6 months of treatment: 2.5 mg twice a day.
- After hip or knee replacement: 2.5 mg twice a day, starting 12 to 24 hours after surgery. Treatment lasts 32 to 38 days after a hip replacement and 10 to 14 days after a knee replacement.
How to take it: swallow the tablet twice a day, with or without food. If you cannot swallow tablets whole, they can be crushed, mixed with water or applesauce and taken right away.
Kidney or liver problems: tell your doctor about any kidney or liver disease. Eliquis is not recommended for people with very poor kidney function, people on dialysis, or people with severe liver disease.
Missed dose: take it as soon as you remember, then carry on with your usual twice-a-day schedule. Do not take a double dose to make up for a missed tablet.
Surgery and dental procedures: when possible, Eliquis is stopped at least 24 hours before a planned procedure, and at least 48 hours before major surgery or a procedure with a high risk of bleeding. Your doctor decides when to stop and when to restart.
Do not stop Eliquis without medical advice. Stopping any blood thinner early raises the risk of clots and stroke.
Storage Instructions
Store at room temperature, between 15°C and 30°C. Keep out of the reach and sight of children.
Side Effects of Eliquis
Bleeding is the most important side effect. It can happen anywhere in the body, and it is not always easy to see. Common effects are nosebleeds, bruising, blood in the urine, anemia and nausea.
In clinical trials:
- Atrial fibrillation (Eliquis compared with warfarin): nosebleeds 6.2% compared with 7.6%, bruising 5.0% compared with 8.2%, and blood in the urine 3.7% compared with 4.5%. Major bleeding happened in 2.13% of people a year compared with 3.09%.
- Treatment of DVT or PE (Eliquis compared with enoxaparin followed by warfarin): major bleeding happened in 0.6% compared with 1.8%.
Get medical help right away if you have:
- Bleeding that is heavy or will not stop
- Black or bloody stools, vomit that looks like coffee grounds, or blood in the urine
- A sudden bad headache, confusion, weakness or vision changes, which can be signs of bleeding in the brain
- After a spinal or epidural procedure: numbness or weakness in the legs, or loss of bladder or bowel control
- Signs of a serious allergic reaction, such as hives, swelling of the face or trouble breathing
Important Safety Information About Eliquis
- Stopping early (serious warning): stopping Eliquis or any blood thinner too soon raises the risk of clots and stroke. Do not stop it unless your doctor tells you to.
- Spinal or epidural bleeding: a spinal or epidural anesthetic or a spinal puncture while you take a blood thinner can cause bleeding around the spine, which can lead to long-term or permanent paralysis. Tell every doctor and dentist that you take Eliquis.
- Do not take Eliquis if you have active serious bleeding, a condition with a high risk of bleeding (such as a recent stroke or an active stomach ulcer that has bled recently), liver disease that affects blood clotting, or an allergy to apixaban or another ingredient.
- Do not combine it with other blood thinners, such as heparin, warfarin, rivaroxaban or dabigatran, unless your doctor is switching you from one to another.
- Do not combine it with the antifungals ketoconazole, itraconazole, voriconazole or posaconazole, or with HIV protease inhibitors such as ritonavir.
- Bleeding risk is higher if you have kidney problems, or if you take NSAIDs, aspirin, other antiplatelet drugs, or SSRI or SNRI antidepressants.
- Pregnancy: Eliquis is not recommended in pregnancy. Tell your doctor if you are pregnant or planning a pregnancy.
- Breastfeeding: it is not known whether apixaban passes into human milk. You and your doctor need to choose between breastfeeding and Eliquis.
Drug Interactions
Tell your doctor, dentist and pharmacist about everything you take, including non-prescription and herbal products. The main interactions are:
- Ketoconazole, itraconazole, voriconazole, posaconazole and ritonavir: must not be taken with Eliquis. They raise the amount of apixaban in the blood.
- Diltiazem, clarithromycin and naproxen: can raise apixaban levels somewhat. No dose change is needed, but they are used with caution.
- Rifampin, phenytoin, carbamazepine, phenobarbital and St. John's wort: lower apixaban levels, so Eliquis may not work as well. They are generally avoided.
- Aspirin and NSAIDs, such as ibuprofen and naproxen: raise the risk of bleeding. Ask before you take any pain reliever.
- Antiplatelet drugs: prasugrel and ticagrelor are not recommended with Eliquis. Clopidogrel is used with caution.
- SSRI and SNRI antidepressants: can add to the risk of bleeding.
- Other blood thinners: not taken together with Eliquis, except during a switch.
Brands & DIN Number of Eliquis
Brand Names
Eliquis
Key Takeaways
- 1Eliquis (apixaban) is a blood thinner authorized in Canada to prevent stroke in atrial fibrillation, to treat and prevent DVT and PE, and to prevent clots after hip or knee replacement.
- 2The usual dose is 5 mg or 2.5 mg twice a day. Treatment of a new DVT or PE starts at 10 mg twice a day for 7 days.
- 3If you miss a dose, take it as soon as you remember and never take a double dose.
- 4Do not stop Eliquis without medical advice, because stopping early raises the risk of clots and stroke.
- 5Bleeding is the main risk. Get medical help right away for heavy bleeding, black stools or a sudden bad headache.
- 6Ask your doctor or pharmacist before taking NSAIDs, aspirin or any new medicine with Eliquis.
- 7Eliquis needs a prescription. Generic apixaban is a regular benefit under BC PharmaCare.
Frequently Asked Questions
How much does Eliquis cost in Canada?
Does BC PharmaCare cover Eliquis?
How do I get Eliquis in BC?
What should I do if I miss a dose of Eliquis?
Do I need to stop Eliquis before surgery or a dental procedure?
Can I take ibuprofen, aspirin or other pain relievers with Eliquis?
Is there a generic Eliquis in Canada?
Is Eliquis different from Xarelto?
Avee Editorial
Avee Editorial Team