Eliquis, the brand name for apixaban, is a blood thinner that is mainly prescribed to people suffering from atrial fibrillation in order to prevent blood clotting and strokes. However, it is also often used to prevent or treat pulmonary embolism (PE) and deep vein thrombosis (DVT); the conditions that cause blood clots in the lung and legs, respectively. In some cases, Eliquis may also be given to patients who have undergone knee or hip replacement surgery to prevent PE and DVT.
What is Atrial Fibrillation?
Atrial fibrillation, commonly known as afib, is a heart rhythm disorder that increases the heartbeat as well as disrupts coordination between the upper and lower chambers of the heart. As a result, the heart fails to pump blood properly.
Atrial fibrillation can be intermittent or persistent and can be symptomatic or asymptomatic.
Many people suffering from a heart condition continue to live without developing any noticeable problems. However, the disorder can significantly increase the risk of a number of health issues, particularly stroke, by reducing the heart’s ability to pump blood and increasing the chances of blood clotting.
If left untreated, atrial fibrillation can weaken the heart, over time, which can then lead to heart failure.
Symptoms of Atrial Fibrillation
While some people may not experience any symptoms, most of the patients suffering from the heart rhythm disorder experience a combination of the following symptoms:
- Weakness and fatigue
- Dizziness or lightheadedness
- Difficulty in breathing, particularly while lying down or performing an activity
- Chest pain
- Heart palpitations i.e. pounding or racing heartbeat
It is important to keep track of your symptoms and their severity, which can change over time, as they help your doctor in diagnosis as well as determine the right treatment method.
How Does Eliquis Help With Atrial Fibrillation?
Commonly known as an anticoagulant or a blood thinner, Eliquis is a factor Xa inhibitor drug that prevents the formation of blood clots by blocking the factor Xa, which then also decreases the risk of stroke.
Factor Xa is an enzyme that is synthesized in the liver and is responsible for the production of thrombin; an essential element in the clot development process.
Available Dosage Forms and Strengths of Eliquis
Eliquis is available in yellow and pink colored tablets in 2.5 mg and 5 mg strengths, respectively.
Eliquis should ideally be stored between 68 to 77 degrees Fahrenheit (20 to 25 degrees centigrade). However, slight temperature variations are permitted; the drug can tolerate temperatures between 59 and 86 degrees Fahrenheit (15 to 30 degrees centigrade).
Recommended Dosage of Eliquis
The drug is generally prescribed in the following dosages; however, the dosage may vary across patients. Therefore, it is recommended to stick to your prescribed dosage and not change it on your own.
For Patients Suffering From Nonvalvular Atrial Fibrillation
Most patients suffering from nonvalvular atrial fibrillation are prescribed to take 5 mg tablets of Eliquis, twice daily. But, you are likely to be prescribed 2.5 mg tablets of Eliquis, twice a day, if you fulfill any two of the following conditions:
- 80 years of age or older
- Weigh 60 kg or less
- Have a serum creatinine level of 1.5 mg/dL or higher
For PE and DVT
Patients with blood clots in the lung(s) and/or leg(s) are generally prescribed 10 mg of Eliquis two times a day during the first week of treatment. The dosage is reduced to 5 mg, twice a day, after the first seven days.
Since blood clots can develop again, the medicine needs to be taken for at least six months after the treatment of both PE and DVT. The recommended preventive dosage of Eliquis for both these conditions is 2.5 mg tablets, twice daily.
To Prevent Blood Clotting After Knee and Hip Replacement Surgeries
Eliquis is often given to patients who have undergone knee or hip replacement surgery for 12 and 35 days, respectively, in order to prevent the formation of blood clots.
2.5 mg tablet, twice a day, is the recommended dose of Eliquis for this purpose.
What to Do In Case Of a Missed Dose?
It is highly recommended to administer the drug as and when prescribed. However, if you happen to miss a dose, take it as soon as possible, so the twice-daily prescribed routine is not disrupted. However, never take a double dose to make up for the missed one.
Signs of Eliquis Overdose
If you have mistakenly overdosed on Eliquis, seek medical help immediately or contact the Poison Control Center at 800-222-1222.
Here are some signs of Eliquis overdose:
- Coughing up blood or strange materials that look like coffee grounds
- Red, pink, or brown urine
- Tarry, red, or black stools
- Unusual bruising or bleeding
How to Take Eliquis
While the ideal way to administer Eliquis is to swallow the whole tablet, its 2.5 mg and 5 mg tablets can be crushed and added to water, apple juice or apple sauce. However, when you do this, make sure to consume the mixture promptly.
Eliquis tablets may also be administered through a nasogastric tube by crushing and mixing with 60 ml of water.
If you are unable to swallow the whole tablets of Eliquis, make sure to consult your doctor to determine the right alternative administration method.
Possible Side Effects of Eliquis
Inform your doctor immediately if you experience any of the following symptoms while taking this anticoagulant medicine:
- Easy bruising
- Back pain
- Tingling or numbness, especially in the legs
- Muscle weakness, particularly in the feet and/or legs
- Reduced or loss of control over bladder and/or bowels
- Brown, red, pink-colored urine
- Black or bloody stool
- Unusual bleeding and/or bleeding that doesn’t stop, including bleeding gums and nosebleeds
- Blood in cough
- Vomit like coffee grounds
- Trouble in breathing
- Severe headache, dizziness, and/or a feeling that you may faint
- Tightness or pain in the chest
- Swelling or pain in joints
- An allergic reaction that can cause swelling of the throat, tongue, lips, and face, or difficulty in breathing, or hives.
Here are a few things that you need to know and remember while taking Eliquis to prevent negative effects:
- Stop taking the anticoagulant if you are to go through an invasive procedure or an elective surgery with the risk of bleeding. The medicine should be discontinued 24 hours before the procedure when the risk of bleeding is low and 48 hours prior to those that involve a moderate or high risk of bleeding.The drug can be restarted once hemostasis has been significantly established.
- Strictly follow the prescribed dosage and continue to take the medicine even if you feel unwell and immediately consult your doctor. Never stop taking Eliquis suddenly as it may increase the risk of stroke.
- The medicine may lead to the development of a serious blood clot around the spinal cord if a patient suffers from a spinal puncture or is given spinal anesthesia or epidural while taking it. In such a scenario, the blood clot could lead to long-term, or even permanent, paralysis.
- Avoid getting involved in tasks or activities that can make you susceptible to injuries or bleeding.
Due to the risk of blood clot formation and consequently paralysis, always tell your doctor if you have or have had a history of having:
- Spinal deformity
- Spinal injury or puncture
- Spinal surgery
- Epidural catheters
It is also important to tell your doctor about any and all drugs (prescription, over-the-counter, herbal, dietary, or recreational) that you are taking before you start taking Eliquis. You should specifically be careful and tell your healthcare provider about the medications that may affect the clotting ability of the drug, such as:
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as Aspirin, Motrin, Advil, Tivorbex, Indocin, Aleve, Naprosyn, Anaprox, and Ketoprofen.
- Agrylin (anagrelide)
- Aggrastat (tirofiban)
- Brilinta (ticagrelor)
- Effient (prasugrel)
- Integrilin (eptifibatide)
- Persantine (dipyridamole)
- Pletal (cilostazol)
- Plavix (clopidogrel)
- Jantoven or Coumadin (warfarin)
It is also crucial to tell your doctor about any health problems that you are currently suffering from or have suffered from in the past, particularly the following ones:
- Liver disease
- Kidney disease
- Medicinal allergies
- Bleeding issues
Also, make sure to tell your doctor that you are taking Eliquis if you weigh 132 pounds or less, are 80 years of age or older, and before undergoing through any dental or medical procedure.
Possible Drug Interactions
Eliquis may interact with some of the medicines that are commonly used in medical emergencies, so make sure that you or a family member informs the doctor or any other healthcare professional that you are taking the medicine, in case a medical emergency arises.
The medicine may also interact with the following drugs and cause negative effects:
- Carbamazepine – Epitol, Equetro, Carbatrol, Teril, orTegretol
- Clarithromycin – Prevpac or Biaxin
- Itraconazole – Sporanox or Onmel
- Ketoconazole – Nizoral
- Phenytoin – Phenytek or Dilantin
- Rifampin – Rifater, Rifadin, or Rimactane
- Ritonavir – Kaletra or Norvir
- John’s Wort
- Selective serotonin reuptake inhibitors (SSRIs), such as Celexa (citalopram), Brisdelle, Pexeva, or Paxil (paroxetine), Luvox (fluvoxamine), Prozac, Sarafem, Selfemra, or Symbyax (fluoxetine), and Zoloft (sertraline)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine), Effexor (venlafaxine), Pristiq or Khedezla (desvenlafaxine), and Savella or Fetzima (milnacipran)
Who Should Not Take Eliquis?
Eliquis may cause you to bruise and/or bleed more easily, so do not take this drug if you:
- Are experiencing active bleeding
- Have an artificial heart valve
While Eliquis has not been found to harm the fetus, it is generally recommended to be avoided during pregnancy as it may increase the risk of bleeding during pregnancy and delivery. However, your doctor can give the best advice regarding this, so always make sure to tell your healthcare provider if you are or planning to become pregnant.
Eliquis should also be avoided by nursing mothers as it has not yet been known whether the drug passes into breast milk or not.
Prescription Assistance for Eliquis
Since Eliquis is an expensive medicine, a large number of people who have been prescribed the drug but are underinsured or uninsured are likely to need prescription assistance for it.
To make sure that the medicine is accessible to everyone who needs it, Bristol-Myers Squibb – the pharmaceutical company that manufactures Eliquis – provides a couple of prescription assistance options.
Under the Eliquis Free Trial Offer, the company provides free of cost medicine for the first month, whereas the Eliquis Co-Pay Card allows patients to acquire the medicine at a significantly lower cost.
Eligible patients can also get Eliquis free of cost. Visit the website of Bristol-Myers Squibb Patient Assistance Foundation to find out if you qualify for it.
Having trouble finding the right assistance program for you?
Call 1-855-354-7847 (1-855-ELIQUIS) between 8am to 8pm (EST) from Monday to Friday and between 9am to 6pm (EST) on Saturday and Sunday for any help regarding prescription assistance for Eliquis.