Apixaban Uses, Dosage, Side Effects, Food Interaction and all others data.

Apixaban acts by inhibiting coagulation, and thus prevents development of blood clots. As a result of FXa inhibition, apixaban prolongs clotting tests such as prothrombin time (PT), INR, and activated partial thromboplastin time (aPTT). Changes observed in these clotting tests at the expected therapeutic dose, however, are small, subject to a high degree of variability, and not useful in monitoring the anticoagulation effect of apixaban.

Apixaban selectively inhibits factor Xa in its free and bound forms, independant of antithrombin III. Apixaban also inhibits prothrominase. These effects prevent the formation of a thrombus.

Trade Name Apixaban
Availability Prescription only
Generic Apixaban
Apixaban Other Names apixabán, Apixaban, apixabanum
Related Drugs aspirin, Xarelto, Eliquis, warfarin, Brilinta, enoxaparin, rivaroxaban, ticagrelor, Coumadin, heparin
Weight 2.5mg, 5mg
Type Oral tablet
Formula C25H25N5O4
Weight Average: 459.4971
Monoisotopic: 459.190654313
Protein binding


Groups Approved
Therapeutic Class Anti-coagulants, Anti-platelet drugs, Fibrinolytics (Thrombolytics), Oral Anti-coagulants
Available Country United States
Last Updated: September 19, 2023 at 7:00 am


Apixaban is a factor Xa inhibitor used:

  • To reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation
  • For the prophylaxis of deep vein thrombosis (DVT), which may lead to pulmonary embolism (PE), in patients who have undergone hip or knee replacement surgery
  • For the treatment of DVT and PE, and for the reduction in the risk of recurrent DVT and PE following initial therapy

Apixaban is also used to associated treatment for these conditions: Deep Vein Thrombosis, Deep vein thrombosis recurrent, Pulmonary Embolism, Recurrent pulmonary embolism, Stroke, Systemic Embolism

How Apixaban works

Apixaban selectively inhibits factor Xa in its free and bound forms, independant of antithrombin III. Apixaban also inhibits prothrominase. These effects prevent the formation of a thrombus.


Apixaban dosage

Reduction of risk of stroke and systemic embolism in nonvalvular atrial fibrillation:

  • The recommended dose: 5 mg orally twice daily.
  • In patients with at least 2 of the following characteristics: age greater than or equal to 80 years, body weight less than or equal to 60 kg, or serum creatinine greater than or equal to 1.5 mg/dL, the recommended dose is 2.5 mg orally twice daily.

Prophylaxis of DVT following hip or knee replacement surgery: The recommended dose is 2.5 mg orally twice daily.

Treatment of DVT and PE: The recommended dose is 10 mg taken orally twice daily for 7 days, followed by 5 mg taken orally twice daily.

Reduction in the risk of recurrent DVT and PE following initial therapy: The recommended dose is 2.5 mg taken orally twice daily.

Side Effects

Apixaban can cause a skin rash or severe allergic reaction.


Animal studies have shown an increased risk of maternal bleeding during pregnancy but no increase in fetal malformations or fetal or maternal deaths. It is unknown if this animal data also translates to humans so apixaban should only be used in pregnancy if the benefits outweigh the risks. It is not know whether apixaban is safe and effective in labor and during birth, though animal studies have shown an increased rate of maternal bleeding. Animal studies in rats show apixaban excreted in milk, though it is not know if this also applies to humans. Nursing mothers should either stop breastfeeding or stop taking apixaban depending on the risk and benefit of each option. Studies to determine safety and effectiveness in pediatric patients have yet to be performed. Studies that involved geriatric patients (at least 75 years old) saw no difference in safety or effectiveness compared to younger patients, though geriatric patients at an especially advanced age may be more susceptible to adverse effects. Dosage adjustments for patients with end stage renal disease(ESRD) are based on estimates of pharmacokinetic principles and not clinical study. Patients with ESRD may experience pharmacodynamics similar to those seen in well controlled studies but it may not lead to the same clinical effects. Dosage adjustments are not necessary in mild hepatic impairment. In moderate hepatic impairment patients may already experience abnormalities in coagulation and so no dose recommendations are possible. Apixaban is not recommended for patients with severe hepatic impairment.


Apixaban can cause serious, potentially fatal, bleeding. Promptly evaluate signs and symptoms of blood loss. An agent to reverse the anti-factor Xa activity of apixaban is available.


Combined P-gp and strong CYP3A4 inhibitors increase blood levels of apixaban. Reduce Apixaban dose or avoid coadministration.

Simultaneous use of combined P-gp and strong CYP3A4 inducers reduces blood levels of apixaban: Avoid concomitant use

Food Interaction

  • Avoid grapefruit products.
  • Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.
  • Avoid St. John's Wort. St. John's Wort will decrease levels of this medication.
  • Take with or without food.

Volume of Distribution

Approximately 21L.

Elimination Route

Apixaban is approximately 50% bioavailable though other studies report 43-46% oral bioavailability.

Half Life



3.3L/h though other studies report 4876mL/h.

Elimination Route

56% of an orally administered dose is recovered in the feces and 24.5-28.8% of the dose is recovered in the urine. 83-88% of the dose recovered in the urine was the unchanged parent compound.

Pregnancy & Breastfeeding use

Pregnancy Category B. There are no adequate and well-controlled studies of Apixaban in pregnant women. Treatment is likely to increase the risk of hemorrhage during pregnancy and delivery. Apixaban should be used during pregnancy only if the potential benefit outweighs the potential risk to the mother and fetus. Treatment of pregnant rats, rabbits, and mice after implantation until the end of gestation resulted in fetal exposure to apixaban, but was not associated with increased risk for fetal malformations or toxicity. No maternal or fetal deaths were attributed to bleeding. Increased incidence of maternal bleeding was observed in mice, rats, and rabbits at maternal exposures that were 19, 4, and 1 times, respectively, the human exposure of unbound drug, based on area under plasma-concentration time curve (AUC) comparisons at the maximum recommended human dose (MRHD) of 10 mg (5 mg twice daily).

Nursing Mothers: It is unknown whether apixaban or its metabolites are excreted in human milk. Rats excrete apixaban in milk (12% of the maternal dose). Women should be instructed either to discontinue breastfeeding or to discontinue Apixaban therapy, taking into account the importance of the drug to the mother.


Active pathological bleeding. Severe hypersensitivity to Apixaban

Acute Overdose

Overdose of Apixaban increases the risk of bleeding. In controlled clinical trials, orally administered apixaban in healthy subjects at doses up to 50 mg daily for 3 to 7 days (25 mg twice daily for 7 days or 50 mg once daily for 3 days) had no clinically relevant adverse effects. In healthy subjects, administration of activated charcoal 2 and 6 hours after ingestion of a 20-mg dose of apixaban reduced mean apixaban AUC by 50% and 27%, respectively. Thus, administration of activated charcoal may be useful in the management of apixaban overdose or accidental ingestion. An agent to reverse the anti-factor Xa activity of apixaban is available.

Interaction with other Medicine

Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Innovators Monograph

You find simplified version here Apixaban

Apixaban contains Apixaban see full prescribing information from innovator Apixaban Monograph, Apixaban MSDS, Apixaban FDA label

*** Taking medicines without doctor's advice can cause long-term problems.