Apixaban

What it is

Apixaban is an oral anticoagulant that inhibits factor Xa, slowing the formation of the fibrin clot. It is used to treat and prevent thrombosis and to reduce the risk of stroke in atrial fibrillation. It acts at a predictable fixed dose and does not require routine clotting measurements.

Used for

• Thrombosis
• Stroke prevention

What to know while taking it

It can be taken with or without food, but it is short-acting and split across the day, so an even spacing matters and a missed dose leaves protection thinner than intended. Acetylsalicylic acid, ibuprofen and anticoagulants such as warfarin all add to the bleeding risk, each in its own way, so combining them is a decision for a doctor rather than a self-medication choice; the same applies to other over-the-counter anti-inflammatory painkillers. Kidney function guides how much of the drug stays in the body, so creatinine and eGFR are monitored, while hemoglobin tracks quiet blood loss. Surgeons and dentists are told about it before any procedure.

When to see a doctor

Prolonged bleeding from small cuts, nosebleeds that will not settle, black stools, blood in urine or vomit, or bruises appearing without cause are reasons to see a doctor. Sudden severe headache, dizziness or weakness, or any blow to the head needs urgent assessment.

Worth knowing

• Raises bleeding risk
• A missed dose matters
• Tell the surgeon before any operation

Markers to watch

• Hemoglobin
• Creatinine
• eGFR