Apixaban (Eliquis) Tablet Side Effects in Pakistan

The primary side effect of Apixaban (Eliquis) is bleeding — this is expected given that it is an anticoagulant. This guide details common, uncommon, and serious side effects — and when to go to emergency immediately.

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

Side Effects

Quick Answer

The most common side effect of Apixaban is bleeding — bruising, nosebleed, prolonged wound bleeding. Serious side effects include major GI bleeding and intracranial haemorrhage (risk lower than warfarin). Go to emergency immediately for unusual or excessive bleeding, severe headache, or vision change. Report any unexpected side effect on the DRAP pharmacovigilance portal.

Side Effects at a Glance

Common

Bruising (easy bruising)
Prolonged wound bleeding
Nosebleed (epistaxis)
Nausea
Anaemia
Menorrhagia

Serious — See a Doctor

Major GI bleeding (gastrointestinal — stomach/intestinal)
Intracranial haemorrhage (brain bleeding — risk lower than warfarin but serious)
Haemoptysis
Thrombocytopenia
Haemorrhagic stroke

When to See a Doctor Immediately

Unusual or excessive bleeding — gums, pink/red urine, black or red stools, excessive bruising
Severe headache or sudden vision change — sign of intracranial haemorrhage
Haemoptysis — blood with breathing (EMERGENCY)
Blood in vomit or coffee-ground vomitus
Severe abdominal pain

Apixaban (Eliquis) Tablet Side Effects (Nuksanat)

Apixaban (Eliquis) is an anticoagulant — therefore bleeding is its primary and expected side effect. In properly managed patients, the benefits outweigh the risks, but it is important to remain aware.

Common Side Effects (Aam Nuksanat)

Bruising — easy bruising
Prolonged wound bleeding — a small cut that bleeds for longer
Nosebleed (epistaxis)
Nausea — usually mild
Anaemia — blood loss from chronic low-level bleeding
Menorrhagia — heavy periods in women

These effects are generally mild and often manageable. Inform your doctor if concerned.

Serious Side Effects (Sanjeedah Nuksanat)

Major GI Bleeding — stomach or intestinal blood — black/tarry stool, blood in vomit — IMMEDIATE EMERGENCY
Intracranial Haemorrhage (brain bleeding) — risk is lower than warfarin but serious — severe headache, vision change, weakness — IMMEDIATE EMERGENCY
Haemoptysis — blood with breathing — IMMEDIATE EMERGENCY
Thrombocytopenia — reduced platelets (rare)

EMERGENCY Signs — Go to Hospital Immediately

These signs are an emergency for anyone taking Apixaban:

Severe headache (sudden onset) — intracranial bleed
Vision change or double vision — brain bleed
Black or tarry stool / blood in stool — GI bleed
Blood in vomit / coffee-ground vomit — upper GI bleed
Pink/red urine — haematuria
Haemoptysis — blood with breathing

Apixaban vs Warfarin — Bleeding Risk Comparison

Bleeding Type	Apixaban	Warfarin
Intracranial haemorrhage	Significantly LOWER	Higher
Major GI bleeding	Comparable	Comparable
Fatal bleeding	Lower with apixaban	Higher

Source: ARISTOTLE trial (NEJM 2011)

Side Effects Summary Table

Type	Side Effect	Action
Common	Bruising	Monitor / inform doctor
Common	Nosebleed	Monitor / inform doctor
Common	Nausea	Monitor
Serious	Major GI bleeding	IMMEDIATE EMERGENCY
Serious	Intracranial haemorrhage	IMMEDIATE EMERGENCY
Serious	Haemoptysis	IMMEDIATE EMERGENCY

Reporting Side Effects

If you notice any unexpected side effect, report it on the DRAP pharmacovigilance portal: https://www.dra.gov.pk/pharmacovigilance

The information in this guide is for educational purposes only. If you notice any side effect, contact your doctor or pharmacist.

Frequently Asked Questions

Apixaban ka sabse bada side effect kya hai?

Bleeding is the primary side effect of Apixaban — bruising, nosebleed, prolonged wound healing. Intracranial bleeding is lower than with warfarin but the risk of major GI bleeding is similar. Inform your doctor immediately for any unusual bleeding.

Kya apixaban warfarin se safer hai?

In the ARISTOTLE trial, Apixaban demonstrated significantly lower intracranial haemorrhage than warfarin — this is a major advantage. However, major GI bleeding was comparable. The overall safety profile is better but each case is different — the doctor will decide.

Apixaban ke saath aspirin aur ibuprofen le sakte hain?

No — combined use of NSAIDs (ibuprofen, naproxen, diclofenac) and aspirin with apixaban significantly increases the bleeding risk. Do not combine without a doctor's advice.

Apixaban band karne par kya hoga?

Stopping apixaban abruptly in AF increases the risk of stroke. Always consult your doctor before stopping for any reason — guided tapering or bridging will be arranged.

Agar surgery zaroori ho aur apixaban le raha hun to kya karein?

Inform your surgeon and prescribing doctor that you are taking apixaban before any surgery. In emergency surgery, inform the hospital. It is typically stopped 24-48 hours beforehand — the doctor will decide the timing.

Sources

DRAP Registered Products Database — Drug Regulatory Authority of Pakistan
WHO Model List of Essential Medicines, 23rd ed. (2023) — World Health Organization
British National Formulary (BNF) — BMJ Group & Pharmaceutical Press

Medical disclaimer

This page is for educational use only and does not replace professional medical advice. Always confirm diagnosis, dose, and interactions with a qualified doctor or pharmacist before starting or changing any medicine.