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Date issued: December 2022

Review date: December 2024

Ref: A-513/NB/ED/Apixaban for Atrial Fibrillation

PDF: Apixaban final December 2022.pdf [pdf] 117KB

Introduction

• You have been given this booklet because we recommend that you are started on a medication called Apixaban (Eliquis), which is a Direct Oral Anticoagulant (DOAC). A health care professional will go through this booklet with you and answer any questions which you may have.

• Apixaban is a medication to reduce the risk of stroke secondary to an abnormal heart rhythm (atrial fibrillation or flutter) by preventing your blood from clotting as quickly as normal.

Why Have I Been Given Apixaban?

• You have been given this medication because you have an irregular heartbeat (atrial fibrillation / flutter), which if left untreated can lead to the formation of a blood clot within your heart. If this clot dislodges, it can travel to your brain, and you may have a stroke. Apixaban can help reduce your risk of having a stroke by reducing your blood’s ability to form clots.

• Apixaban is recommended particularly in those considered to be at higher risk of stroke (i.e., 1 in 100 or greater risk, per year). In clinical trials of patients with atrial fibrillation and increased stroke risk, Apixaban has been shown to significantly reduce the risk of stroke and mortality in the long term (i.e., to improve survival).  However, it needs to be taken exactly as prescribed in order to work properly.

• In most patients, their greater risk of a blood clot and stroke remains, even if their heart rhythm is normalised. Therefore, in the majority, anticoagulant medication such as Apixaban is recommended life-long. This point will be clarified with you by a health care professional, as appropriate.

How Do I Take Apixaban?

• Apixaban is usually prescribed at a dose of 5 mg twice a day. However, the dose is reduced to 2.5mg twice daily if any two out of the following three factors apply: (1) You are aged 80 years or older; (2) Your body weight is less than 60kg; (3) Your kidney function is abnormal. This will be explained by a health care professional, as required.

• If you forget to take a dose you should take it as soon as you remember and then take your next dose at the usual time. However, if you only remember at the time when your next dose is due, simply take your usual dose and continue as usual thereafter (i.e., you should never take a double dose).
• You should try to take Apixaban at the same time each day, and approximately 12 hours apart.  The tablet should be swallowed whole with water.

Are There Any Side-Effects?

• Most patients tolerate this medication well, but the main side effect of apixaban is that it can cause you to bleed more easily. Therefore, if you experience any of the following you should stop taking this medication and seek advice from your GP:

  • Bleeding that does not stop after about 5 minutes

  • Blood in your urine or stools

  • Coughing or vomiting blood

  • Unusual bruising

• You will find a detailed list of side-effects on the information sheet in your medication packet.

What Do I Do Now?

• Please take your medication as directed.

• The Doctor who has seen you in ED will write to your GP explaining that we have treated you for atrial fibrillation or flutter with this medication.

• We advise you to make an appointment to see your GP in the next 2 weeks for a review of your condition and medication.