Apixaban (Eliquis): a clear, practical guide

Apixaban is a modern oral blood thinner many doctors prescribe to prevent strokes and treat blood clots. If you or someone close to you was given apixaban, this page explains what it does, how to take it, common risks, and simple safety tips you can use day to day.

How apixaban works and when it's used

Apixaban blocks part of the clotting system (factor Xa). That lowers the chance clots form in the heart or veins. Doctors commonly use it for: non-valvular atrial fibrillation (to prevent stroke), treating deep vein thrombosis (DVT) and pulmonary embolism (PE), and routine clot prevention after some surgeries.

Typical doses you’ll hear about: for atrial fibrillation most people take 5 mg twice a day. Some people need 2.5 mg twice daily if they’re older, weigh little, or have specific kidney results. For a new DVT or PE the usual start is 10 mg twice daily for 7 days, then 5 mg twice daily. Always follow your prescriber's plan — individual needs change.

Common side effects, risks, and interactions

The most important risk is bleeding. Nosebleeds, heavy menstrual bleeding, or bruises that appear easily are common warnings. Serious bleeding (internal or brain) is rare but possible. Call emergency services if you have unexpected severe bleeding, pass black stool, vomit blood, or feel faint.

Drug interactions matter. Strong inhibitors of CYP3A4 and P-gp (like ketoconazole or ritonavir) can raise apixaban levels and increase bleeding risk. Strong inducers (like rifampin or carbamazepine) can lower its effect and raise clot risk. Combining apixaban with NSAIDs, aspirin, or SSRIs/SNRIs raises bleeding risk too. Tell every provider and pharmacist you take apixaban before they prescribe anything.

If you need urgent reversal for major bleeding or emergency surgery, andexanet alfa (Andexxa) may be used in hospitals. Not every center stocks it, so show medical staff a list of your meds and the last time you took apixaban.

Practical tips: take apixaban twice daily at the same times each day, with or without food. If you miss a dose, take it as soon as you remember unless the next dose is close — don’t double up. Store it in a cool, dry place and keep it away from children. Don’t stop apixaban without checking with your doctor — stopping suddenly can raise your clot risk.

Questions for your prescriber: ask why apixaban was chosen for you, how long you’ll need it, what to do before procedures, and when to seek urgent care. That short conversation can prevent problems and keep you safer on treatment.