Apixaban Tablet: Uses, Dosage & Side Effects in Pakistan

Apixaban Tablet Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Apixaban Tablet? (Apixaban kya hai)

Apixaban (Eliquis) is a direct oral anticoagulant (DOAC) that directly blocks Factor Xa — preventing thrombosis by interrupting the blood clotting cascade. In Pakistan it is used to prevent stroke in atrial fibrillation, to treat DVT (deep vein thrombosis) and PE (pulmonary embolism), and to prevent post-surgical blood clots. Compared to warfarin, apixaban has key advantages: no INR monitoring required, fixed dosing, and lower risk of intracranial bleeding.

3. Uses (Fayde / Kis kaam aata hai)

• Non-valvular Atrial Fibrillation: Stroke and systemic embolism prevention in AF — preventing blood clot formation
• DVT Treatment and Prevention: Treating deep vein thrombosis and preventing recurrence
• Pulmonary Embolism (PE): Treating and preventing blood clots in the lungs
• Post-Surgical VTE Prophylaxis: Blood clot prevention after hip or knee replacement surgery
• Recurrent VTE Prevention: Preventing recurrent DVT/PE

4. Who Should Take (Kis ko lena chahiye)

• Stroke prevention in AF patients (non-valvular AF)
• Treatment after DVT or PE diagnosis
• VTE prophylaxis after hip/knee replacement surgery
• High-risk patients for recurrent VTE

5. When NOT to Take (Kab nahi lena chahiye)

• Active pathological bleeding
• Mechanical heart valves or antiphospholipid syndrome — warfarin preferred
• Severe hepatic disease (Child-Pugh C)
• Severe renal impairment — guidance from doctor required
• Pregnancy — discuss with doctor (DOACs generally avoided in pregnancy)
• Allergy to apixaban or any ingredient

6. Dosage (Kitni leni hai)

• Standard: 5mg twice daily (BD)
• Dose Reduction: 2.5mg BD IF patient has ≥2 of: age ≥80, weight ≤60kg, serum creatinine ≥133 µmol/L (ARISTOTLE trial criteria)

• First 7 days: 10mg twice daily (BD)
• After 7 days: 5mg twice daily (BD)

• 2.5mg twice daily — duration depends on surgery type

• Take as soon as possible on the same day, then resume the normal schedule. Do not take a double dose.

7. How to Take (Kaise lena hai)

• With or without food — both are acceptable
• Take at regular times — routine is crucial for anticoagulation
• Ideally do not crush or split the tablet — consult your doctor if needed
• Inform all doctors and surgeons that you are taking apixaban — temporary interruption may be required for procedures

8. Best Time (Kab lena chahiye)

• Twice daily — morning and night — same times each day
• Maintain routine — a missed dose increases stroke risk

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

• Apixaban may be taken with or without food — no significant food interaction (unlike warfarin).

10. Warnings (Ihtiyat)

• Any unusual bleeding — gums, discoloured urine, black stool, excessive bruising — inform your doctor immediately
• Before surgery or dental procedures, always inform your doctor and surgeon/dentist that you are taking apixaban — ask about the timing for stopping it

• Do not stop apixaban in AF without medical advice — stroke risk increases suddenly

• Apixaban is not effective for mechanical heart valves or antiphospholipid syndrome — warfarin is used in these cases

• Andexanet alfa (specific reversal agent) is not widely available or affordable in Pakistan — special management is required for major bleeding

11. Precautions (Ahm ehtiyaat)

• Below 30°C, in original packaging
• Keep out of the reach of children

• Kidney function regular check — dose adjustment needed in renal impairment

12. Side Effects (Nuksanat)

• Bruising and prolonged wound bleeding
• Nosebleed (epistaxis)
• Nausea
• Anaemia
• Menorrhagia (heavy periods) in women

• Major GI bleeding — seek doctor/emergency immediately
• Intracranial haemorrhage (risk lower than warfarin but still serious)
• Thrombocytopenia (rare)
• Elevated liver enzymes (rare)

13. Drug Interactions (Dawaon ke saath reaction)

• P-gp + CYP3A4 strong INHIBITORS (ketoconazole, ritonavir, clarithromycin) — significantly increase apixaban levels → major bleeding risk. Avoid strong dual inhibitors.
• P-gp + CYP3A4 strong INDUCERS (rifampicin, carbamazepine, phenytoin) — significantly reduce apixaban levels → thrombosis/stroke risk. Avoid combination.
• NSAIDs + Aspirin (ibuprofen, naproxen) — additive bleeding risk — use cautiously
• Other anticoagulants — avoid concurrent use
• Fluconazole (moderate inhibitor) — use with caution, discuss with doctor

14. When to See Doctor (Kab doctor ke paas jayein)

• Unusual or excessive bleeding — gums, pink/red urine, black/red stools, excessive bruising
• Severe headache or vision changes — sign of intracranial haemorrhage (emergency)
• Haemoptysis
• Blood in vomit
• Any planned surgery or dental procedure

15. Alternatives (Sasti ya Dosri Dawaein)

16. Price in Pakistan (Price kitni hai)

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17. FAQs (Aksar poochay jane walay sawalat)

Q: Apixaban kis kaam aata hai?

A: Apixaban is used to prevent stroke in AF, treat DVT and PE, and prevent post-surgical blood clots.

Q: Apixaban vs warfarin kaunsa better hai?

A: Apixaban requires no INR monitoring, has lower intracranial bleeding risk, and uses fixed dosing. Warfarin is preferred for mechanical valves and APS. Your doctor will decide which is right for you.

Q: Apixaban ke side effects kya hain?

A: Bruising, nosebleed, and nausea are common. Major bleeding is a serious side effect — see a doctor immediately.

Q: Apixaban price Pakistan mein kitni hai?

A: Confirm at your local pharmacy or Dawaai.pk — prices vary.

Q: Apixaban lene ke saath kya nahi khana chahiye?

A: NSAIDs (ibuprofen) and aspirin increase bleeding risk. Strong antifungals (ketoconazole) and HIV medicines (ritonavir) increase apixaban levels. Inform your doctor of all medicines.

18. Medical Review (Medical jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.