Eliquis contains the active substance called apixaban. It is part of the class of medications known as anticoagulants. This medication helps prevent blood clots from developing by blocking the formation of Factor Xa, which is a key component of blood clotting.
Eliquis is used in adults:
to prevent the formation of a blood clot in the heart in patients with irregular heart beats (atrial fibrillation) and at least one additional risk cause. Clots of blood can break and move through the brain and eventually lead to a stroke or other organs, and hinder regular blood flow to this organ (also called an embolism in the system). A stroke can be life-threatening and requires immediate medical intervention.
to treat blood clots that have formed in blood vessels in your legs (deep vein thrombosis) and also in the blood vessels of your lung (pulmonary embolism) and to stop blood clots recurring in the blood vessels of your lungs or legs.
You are allergic to apixaban or any of the other ingredients in this medicine (listed at section 6);
If you’re bleeding a lot,
there is a disease that affects an organ of the body which increases the risk of serious bleeding (such as active or a recent ulcer in your stomach or bowel, recent bleeding in your brain);
If you suffer from a liver disorder, that can increase the risk for bleeding (hepatic coagulopathy);
you’re taking medication to reduce the risk of the formation of blood clots (e.g. warfarin, dabigatran, rivaroxaban, or heparin), except when switching anticoagulant treatments, you have a venous or arterial line, and you receive heparin in this line in order to maintain its open, or if a tube has been put into the blood vessels (catheter ablation) to treat irregular heartbeats (arrhythmia).
Consult your physician or pharmacist before you begin taking this medicine in case you have one or more of the following:
An increased risk of bleeding for example:
bleeding disorders, which include conditions which cause decreased platelet activity;
extremely high blood pressure that is not controlled by medication;
If you are over 75 years;
you weigh 60kg or less.
a serious kidney disease, or if you are on dialysis;
an issue with the liver or a history of liver problems;
The use of this medicine is with caution in patients suffering from evidence of impaired liver function.
If you have a prosthetic heart valve
If your doctor decides the blood pressure is unstable or another treatment or surgical procedure to remove the blood clots from your lungs is being planned.
Make sure you take special care of Eliquis
if you know you are suffering from a condition known as antiphospholipid disease (a disease caused by the immune system and leads to an increase in the likelihood of blood clots), tell your doctor who will determine if the treatment is required to be modified.
If you’re required to undergo surgery or a procedure which could cause bleeding, your doctor might ask you to discontinue taking this medication for a short while. If you’re unsure whether the procedure you are having may result in bleeding, talk to your doctor.
Find out more on the Eliquis savings card at this website.
This medication is not recommended for use in adolescents or children who are less than 18 years old.
Speak to your doctor, pharmacist or nurse if taking, or have recently taken or could be taking any other medications.
Certain medicines can enhance its effects Eliquis and others may reduce the effects of Eliquis. Your doctor will decide, whether you need to be treated by Eliquis in conjunction with these medicines and how often you should be monitored.
The following drugs may intensify effect of Eliquis in addition to increasing the risk for bleeding issues:
Certain medicines to treat fungal infections (e.g. ketoconazole etc. );
Certain antiviral medications to treat HIV / AIDS (e.g., ritonavir);
Other medicines are also used to stop bleeding (e.g., enoxaparin, etc. );
anti-inflammatory or pain medicines (e.g. Acetylsalicylic Acid (or naproxen). Particularly, if over 75 years old and taking acetylsalicylic acid, you may have an increased risk of bleeding;
medications to treat high blood pressure or heart issues (e.g., diltiazem);
antidepressants, also known as selective serotonin re-uptake inhibitors , or serotonin norepinephrine re-uptake inhibitors.
The following drugs may hinder the ability of Eliquis to prevent blood clots form:
medication to treat epilepsy or seizures (e.g., phenytoin, etc. );
St John’s Wort (a herbal supplement for depression);
drugs to treat tuberculosis and other infections (e.g. Rifampicin, for example).
If you’re expecting or breastfeeding, and you think that you could be pregnant, or are planning to bear a baby, ask your physician, pharmacist or nurse for advice before using this medicine.
What effects Eliquis on the fetus and the unborn baby are not discovered. Do not take this medication if you are pregnant. Contact your doctor immediately if you are pregnant while you are taking the medication.
It isn’t known it is not known if Eliquis is absorbed into human breast milk. Contact your physician, pharmacist or nurse for guidance before using this medicine while breastfeeding. They will advise you whether to stop breast-feeding or to stop or not start taking this medicine.
Eliquis is not known to impair your ability to operate machines or drive.
If you’ve been advised by your doctor you are allergic to certain sugars, contact your doctor before you start taking this medicine.
This medicine contains less than 1 mmol sodium (23 mg) per tablet. That means it is “sodium-free”.
Be sure to take this medicine exactly as your doctor or pharmacist has instructed you to. Consult your physician or pharmacist If you’re unsure.
Drink the tablet in drinking a glass of water. Eliquis can be taken with or without food.
Make sure to take the tablets at the same times throughout the day to ensure the best effect.
If you are having difficulty swallowing the tablet in its entirety Talk to your physician about other ways to take Eliquis. The tablet could be crushed and then mixed with water, or 5% sugar in water Apple juice, or puree of apples prior to taking it.
Crush the tablets with the help of a mortar and pestle.
Place the entire powder into a container suitable for the task, and mix the powder in a little e.g., 30 mL (2 tablespoons) water or any other liquids discussed in the previous paragraphs to create a mixture.
Suck the mixture in.
Rinse the mortar and the pestle you used for crushing the tablet and the container, with a little water or various liquids (e.g. 30 milliliters) and then drink the rinse.
If necessary, your doctor could also prescribe crushing Eliquis tablet mixed in 60 milliliters of liquid or 5% glucose in water, via a nasogastric tube.
To prevent the formation of blood clots in the heart of patients with an irregular heart beat or at the very least an additional risk factors.
The recommended dose includes one tablet Eliquis 5 mg once each day.
The recommended dose is one tablet of Eliquis 2.5 mg twice per day if you:
You have a severely degraded kidney function;
two (or more) of the following apply to you:
your blood test results suggest the presence of kidney dysfunction (value of serum creatinine 1.5 mg/dL (133 micromole/L) or higher);
you’re 80 years old or older.
Your weight should be 60kg or less.
The recommended dose is one tablet twice per day, for example taking one in the early morning and the other at night.
The doctor will decide on the length of time you have to continue treatment for.
To treat blood clots within the veins in your legs and blood clots in the blood vessels in your lungs.
The recommended dose should be two pills of Eliquis 5 mg twice per each day for the first 7 days. For example, two in the morning and two in the evening.
After 7 days the suggested dosage is one tablet of Eliquis 5 mg once a day, such as first thing in the morning, and one at night.
For preventing blood clots from re-occurring following completion of 6 months of treatment
The recommended dosage should be one tablet Eliquis 2.5 mg twice a day, for example, one in the morning and the other in the evening.
The doctor will decide on how long you must continue treatment for.
Your physician may modify the anticoagulant medication as follows:
Changing from Eliquis to anticoagulant drugs
Stop taking Eliquis. Start treatment with the anticoagulant medications (for instance, heparin) when you took the next tablet.
Moving from anticoagulant drugs to Eliquis
Stop taking the anticoagulant medicine. Start treatment with Eliquis when you would have taken your second dose of your anticoagulant medication Then continue your treatment as normal.
Moving from anticoagulant treatment which contain Vitamin K antagonist (e.g. warfarin, for example) to Eliquis
Stop taking the medicine containing vitamin K antagonist. Your doctor needs to do blood-measurements and instruct you when you should begin taking Eliquis.
Moving from Eliquis to anticoagulant therapy containing vitamin K antagonist (e.g. warfarin, for instance).
If your doctor advises that you should begin taking the medication containing vitamin K antagonists, continue to take Eliquis for at least two days after taking your first dose that contains an antagonist to vitamin K. Your doctor will need to take blood-measurements and instruct you when you should stop taking Eliquis.
If your abnormal heartbeat needs to be restored to normal, using a process called cardioversion, take this medication at the time your physician advises you to that you should, in order to avoid blood clots from blood vessels in the brain as well as in other blood vessels throughout your body.
Tell your doctor immediately if you have taken more than prescribed dose of Eliquis. Keep the pack of medicine with you even if you have no tablets remaining.
If you are taking more Eliquis than suggested, you may have an increased chance of bleeding. If bleeding does occur after surgery, blood transfusions or other treatments that reverse anti-factor Xa activity may be required.
Dose the medication as when you remember it and:
The subsequent doses of Eliquis at the usual time;
then continue as normal.
If you’re unsure what to do, or skipped more than one dosage of medication, ask your pharmacist, doctor or nurse.
Don’t discontinue taking this medication without talking to your doctor first, due to the possibility of developing a blood clot may be greater If you stop treatment early.
If you have any additional questions regarding the use of this medication, consult your doctor, pharmacist or nurse.
Like all medications that are prescribed, this one can trigger side effects, although not everybody gets them. The most commonly reported adverse effect that this medication can cause is bleeding, which could be life-threatening and requires immediate medical attention.
The following adverse effects are known if you are taking Eliquis to prevent the formation of a blood clot within the heart of people with an irregular heart beat as well as at least one other risk factors.
Common adverse side effects (may be affecting up to one out of 10 individuals)
Bleeding including:
with your eyes.
In your stomach or bowel;
from your rectum
Blood in the urine
from your nose;
away from your gums
bruising and swelling;
Anaemia which may cause tiredness or pallor;
Low blood pressure which may make you feel fainter or have a quickened heartbeat;
Nausea (feeling sick);
Tests of blood may reveal:
an increase in gamma-glutamyltransferase (GGT).
Uncommon side effects (may be affecting up to one in 100 people)
Bleeding:
within your brain or your spinal column;
in your mouth or blood from your spit after coughing;
through your abdomen, or from your vagina;
The stool is bright red with blood;
bleeding occurring after your operation which may cause swelling and bruising fluid or blood leaks from the surgical wound/incision (wound secretion) or injection site
from a haemorrhoid;
tests showing blood in the stools or in the urine;
There is a decrease in the number of platelets present in your blood (which can interfere with clotting);
Blood tests may show:
abnormal liver function;
an increase in some liver enzymes.
An increase in bilirubin which is a product that breaks down red blood cells. It causes yellowing of the eyes and skin.
Itchy skin;
Itching;
Hair loss;
The allergic reaction (hypersensitivity) that could cause: swelling of the face, lips or tongue. It can also cause swelling of the mouth, throat, and breathing difficulties. Inform your doctor right away when you notice one of the symptoms listed above.
Rare adverse reactions (may affect up to 1 in 1,000 people)
Bleeding:
in your lungs , or in your throat;
into the abdominal cavity;
into a muscle.
Very rare side consequences (may be the cause of up to one out of 10,000)
Skin rash which may form blisters and looks like small spots (central dark spots, surrounded by a lighter-colored area with a dark-colored ring around the edge) (erythema multiforme).
Unknown (frequency can’t be determined using the data available)
Inflammation of blood vessels (vasculitis) which may result in skin rash or flat, pointed circular, red spots under the skin’s surface, or in bruises.
The following adverse effects are known in the event that you use Eliquis to treat or prevent re-occurrence of blood clots inside the veins of your legs and blood clots within the blood vessels of your lungs.
Common side effects (may affect as many as 1 in 10 people)
Bleeding includes:
from your nose;
Remove your gums
Urine blood that is bloody;
Ailment and swelling,
in your stomach, your bowels, and your rectum;
in your mouth;
via the vagina
Anaemia can cause fatigue or paleness
The number of platelets is reduced found in blood (which can impact clotting);
Nausea (feeling sick);
The rash on the skin;
Blood tests may show:
an increase in gamma-glutamyltransferase (GGT) or alanine aminotransferase (ALT).
Common side effects (may cause up to 1 in 100 people)
Low blood pressure , which can make you feel faint or feel your heart beat is faster;
Bleeding:
In your eyes;
in your mouth or blood in your spit after coughing;
Blood that is bright/red in the stool;
tests that show blood in the stool or in the urine;
bleeding that occurs after any surgery such as swelling and bruising, bleeding of liquid or blood out of the surgical incision (wound discharge) as well as the injection area
from a haemorrhoid;
into a muscle;
Itching;
Hair loss;
Allergy reactions (hypersensitivity) which may cause: swelling of the lips, face mouth, tongue, throat, and breathing difficulties. Inform your doctor as soon as you experience any of these symptoms;
The results of blood tests could reveal:
Affected liver function
an increase in certain liver enzymes;
the increase in bilirubin a breakdown product of red blood cells. This can cause yellowing of skin and eyes.
Rare adverse reactions (may affect up to 1 of 1,000)
Bleeding:
within your brain or the spinal column of your brain;
in your lungs.
Not yet known (frequency is not able to be calculated from the available data)
Bleeding:
in your abdomen or through the abdominal cavity.
The skin rash can develop blisters , and appears like small spots (central dark spots surrounded an area that is lighter, and a some dark spots around the edge) (erythema multiforme);
The inflammation of blood vessels (vasculitis) which can cause skin rashes or pointed flat, red small, round spots beneath the skin’s surface, or in bruises.
If you get any side symptoms, speak to your pharmacist, doctor, or nurse. This includes any negative side effects not covered in this booklet. It is also possible to report side reactions directly (see more details below). If you report side effects, you can help provide more information on the safety of this medicine.
Yellow Card Scheme
Website: www.mhra.gov.uk/yellowcard
or go to MHRA Yellow Card on Google Play or Apple App Store. Google Play or Apple App Store
Keep this medicine out of sight and reach of children.
Do not use this medicine following the expiry date that is listed on the carton and on the blister following EXP. The expiry date refers to the last day of that month.
This medicine is not subject to any special storage conditions.
Do not dispose of medicine in household waste. Consult your pharmacist about how to dispose of medications that you no longer require. These steps will help safeguard the environment.
The active substance is called apixaban. Each tablet includes 5 mg of apixaban.
The other ingredients are:
Tablet core contains lactose (see the section 2 “Eliquis has lactose (a type of sugar) and sodium”), microcrystalline cellulose and Croscarmellose sodium (see section 2 “Eliquis has lactose (a type of sugar) and sodium”), sodium laurilsulfate, magnesium Stearate (E470b);
Film coat film coat contains lactose monohydrate (see section 2 “Eliquis is a mixture of lactose (a kind of sugar) and sodium”) (E464), hyporomellose (E464) titanium dioxide (E171) triacetin, ferrous oxide red (E172).
The tablets coated with film are pink oval (9.73 millimeters) 9.73 mm x 5.16 millimeters) and are marked by “894” on one side along with “5” to the opposite side.
They come in blisters in cartons of 14, 20, 28, 56 60, 168, and 200 film-coated tablets.
Unit dose blisters packed in cartons of 100×1 film coated tablets that can be delivered to hospitals are also available.