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Apixaban Side Effects

Apixaban Side Effects: What You Must Know for Safer Use

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Understanding how Apixaban affects the body, including both common and serious side effects, can help patients and caregivers manage their treatment effectively. This medication, commonly sold under the brand name Eliquis, is an anticoagulant used to reduce the risk of stroke and blood clots in conditions like atrial fibrillation (AFib) and deep vein thrombosis (DVT). While it is highly effective, patients should be aware of potential Apixaban side effects to ensure safe use.

How Apixaban Works

Apixaban is a direct oral anticoagulant (DOAC) that works by selectively inhibiting Factor Xa, a crucial enzyme in the clotting process. By blocking this enzyme, Apixaban reduces the risk of harmful blood clots forming in conditions like atrial fibrillation, deep vein thrombosis (DVT), and pulmonary embolism (PE). Its predictable anticoagulant effects make it a preferred choice for many patients, as it provides reliable stroke and clot prevention without the dietary restrictions associated with older blood thinners.

Unlike warfarin, Apixaban does not require routine blood monitoring, making it more convenient for long-term use. However, while it simplifies anticoagulation therapy, its effects should still be closely observed, especially in patients with kidney impairment or those at risk of excessive bleeding. Since there is no routine test to measure its activity, patients should remain aware of potential side effects and interactions. Consulting a healthcare provider regularly ensures that Apixaban remains a safe and effective option for clot prevention.

Common Side Effects of Apixaban

Most side effects of Apixaban are mild and manageable, but they should still be monitored to ensure treatment remains safe.

1. Increased Bleeding and Bruising

Because Apixaban reduces the blood’s ability to clot, mild bleeding is one of its most common side effects. This may include:

  • Frequent nosebleeds
  • Easy bruising
  • Prolonged bleeding from minor cuts
  • Bleeding gums after brushing or flossing

Patients should take precautions to prevent injuries and report any unusual bleeding to their doctor.

2. Nausea and Stomach Discomfort

Some individuals experience mild nausea, indigestion, or stomach pain when starting Apixaban. Taking the medication with food may help reduce discomfort.

3. Anemia (Low Red Blood Cell Count)

Prolonged use of Apixaban can sometimes lead to mild anemia, which may cause symptoms like fatigue, dizziness, and pale skin. Routine blood tests can help monitor for this condition.

Apixaban Major Side Effects

While most side effects are mild, Apixaban major side effects require immediate medical attention.

1. Severe Bleeding Events

Although rare, major bleeding complications can occur, particularly in individuals with a history of ulcers, recent surgery, or other bleeding disorders. Signs of serious bleeding include:

  • Blood in the urine or stool
  • Coughing up blood
  • Severe or persistent headaches, which may indicate internal bleeding

Patients experiencing these symptoms should seek emergency medical care.

2. Allergic Reactions

Some individuals may develop an allergic reaction to Apixaban, which can cause:

  • Skin rash or hives
  • Swelling of the face, lips, or throat
  • Difficulty breathing

These symptoms require immediate medical attention.

3. Liver Problems

In rare cases, Apixaban can affect liver function. Symptoms of liver issues include jaundice (yellowing of the skin or eyes), dark urine, and persistent nausea. Patients should inform their doctor if they experience these symptoms.

Apixaban Side Effects in Elderly Patients

Elderly patients are more susceptible to Apixaban side effects, particularly those related to bleeding and kidney function.

1. Increased Bleeding Risk

Older adults may have a higher risk of major bleeding due to changes in metabolism and overall health. Even minor injuries can result in prolonged bleeding, so extra caution is advised.

2. Dizziness and Falls

Some elderly individuals may experience dizziness, increasing the risk of falls and injuries. Using assistive devices or moving carefully can help prevent accidents.

3. Kidney Function Considerations

Since Apixaban is partially eliminated through the kidneys, elderly patients with reduced kidney function may require a lower dose to prevent drug accumulation and excess bleeding risk.

Managing Apixaban Side Effects

Most side effects of Apixaban can be managed with a few simple precautions:

1. Monitor for Signs of Bleeding

Be aware of unusual bruising, prolonged bleeding, or changes in stool color. Report any severe bleeding episodes to your doctor immediately.

2. Take Apixaban as Prescribed

Stick to the recommended dosage and schedule to maintain consistent blood levels and effectiveness. Avoid skipping doses or doubling up after a missed dose.

3. Maintain a Healthy Lifestyle

A balanced diet and regular hydration can support overall well-being and reduce stomach discomfort. Avoid excessive alcohol intake, which can increase bleeding risks.

4. Inform Healthcare Providers Before Procedures

Before any surgery or dental work, inform your doctor that you are taking Apixaban. They may adjust your medication temporarily to minimize bleeding risks.

Takeaways

Apixaban is a widely used anticoagulant that helps prevent blood clots, reducing the risk of stroke and other serious complications. While it is generally well-tolerated, understanding Apixaban side effects is crucial for safer use. 

Most side effects, such as mild bruising or nausea, are manageable, but more serious risks, including excessive bleeding, can occur. Certain individuals, such as elderly patients or those with kidney impairment, may be at a higher risk of complications, making close monitoring essential. Recognizing early signs of unusual bleeding, such as prolonged nosebleeds, blood in urine, or excessive bruising, can help prevent severe outcomes.

If any concerning symptoms arise, such as dizziness, weakness, or unexpected bleeding, seeking medical advice promptly is important. By staying informed and following medical guidance, patients can use Apixaban safely and effectively for clot prevention while minimizing potential side effects.

Frequently Asked Questions (FAQs)

What should I do if I experience severe bleeding while taking Apixaban?

If you experience severe bleeding, such as blood in your stool or urine, seek immediate medical attention. Do not stop Apixaban without consulting your doctor.

Can Apixaban be stopped suddenly?

No, stopping Apixaban suddenly can increase the risk of blood clots. Always consult your doctor before discontinuing use, as they may recommend a gradual tapering plan.

How long does Apixaban stay in your system?

Apixaban has a half-life of about 12 hours, meaning it takes approximately 24-48 hours for the drug to be fully eliminated from the body after stopping treatment.

Is Apixaban safe for long-term use?

Yes, Apixaban is safe for long-term use when taken as prescribed. However, regular monitoring is recommended, especially in elderly patients and those with kidney issues.

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Written by BFH Staff Writer on February 10, 2025

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