Common questions about apixaban

Apixaban is a type of medicine known as an anticoagulant. It makes your blood clot more slowly.

Blood clotting (thickening) is a complicated process involving substances called clotting factors.

Clotting factors are made by the liver and help stop bleeding. They work with blood cells called platelets that trigger the clotting process to make sure your blood clots properly.

Apixaban works by stopping a clotting factor called factor Xa working. This makes it take longer for your blood to clot.

Apixaban works within a few hours of taking it.

Apixaban is safe to take for a long time.

There do not seem to be any lasting harmful effects from taking it for many months or even years.

Do not stop taking apixaban without talking to your doctor.

If you stop taking apixaban, the rate at which your blood clots will return to what it was before you started taking it, usually within a day or two of stopping.

This means that you may be at increased risk of serious problems like stroke, heart attack, deep vein thrombosis or pulmonary embolism.

There are several other anticoagulants available as tablets or capsules.

They include:

• rivaroxaban
• dabigatran
• edoxaban
• warfarin

There are also anticoagulants that you take by injecting them. These include:

• heparin
• enoxaparin
• dalteparin
• tinzaparin

Not all medicines that prevent blood clots are suitable for everyone.

Talk to your doctor or pharmacist to find out why you have been recommended a particular medicine.

You will need to carry an anticoagulant alert card with you at all times.

If you have an accident, it's important that the person treating you knows you are taking an anticoagulant.

Because of the risk of bleeding, your dose of apixaban may need to be lowered or stopped a few days before you have an operation.

Tell the surgeon that you're taking apixaban and show them your anticoagulant alert card.

Also tell anyone else involved with your care, such as your anticoagulant specialist, so they can arrange any changes to your medicine for you.

You can still go to your dentist as usual.

But tell your dentist that you're taking apixaban, and show them your anticoagulant alert card, before you have any treatment.

This is especially important if you need to have a tooth out.

Most people do not need to change their apixaban dose, but your dentist may contact your doctor for advice before starting the dental treatment.

Having a body piercing or tattoo is not recommended while you're taking apixaban.

This is because of the increased risk of bleeding and infection.

If you still want to go ahead, talk to your doctor about your specific risks in case you need antibiotics.

And let the tattooist or piercer know beforehand that you're taking an anticoagulant medicine.

Some people report hair loss when taking certain anticoagulants.

Apixaban does not seem to affect the hair or cause hair loss.

But if you have any concerns about your hair while taking this medicine or you notice any changes, speak to your doctor or pharmacist.

You can have vaccinations while taking apixaban. Before you have them, be sure to show your anticoagulant alert card to the nurse or doctor. It's important to tell them that you're taking apixaban, in case there's any bleeding at the site of the injection.

It might help prevent bruising if you press on the injection site for 10 minutes after the vaccination.

You can continue to take part in non-contact sports, such as running, athletics, cycling, tennis and badminton.

But be sure to use the right protective clothing or equipment, like wearing a helmet when riding your bike.

Avoid all contact sports, particularly martial arts and kickboxing.

This is because these types of sports can lead to an injury, which would further increase the risk of bleeding.

Apixaban does not affect any type of contraception, including the combined pill and emergency contraception.

Most people can drive or ride a bike while taking apixaban. But if taking apixaban makes you feel dizzy or light-headed, do not drive or cycle until this feeling goes away.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking apixaban. GOV.UK has more information on the law on drugs and driving.

You can drink alcohol while taking apixaban as long as you do not drink more than 14 alcohol units a week.

A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.

Drinking heavily, especially binge drinking lots of alcohol in one go, is dangerous while taking apixaban. The alcohol can increase the risk of bleeding.

Apart from being careful with alcohol, there are no foods or drinks you need to avoid while taking apixaban.

It's thought that cannabis can increase your risk of serious bleeding.

It's not clear how other recreational drugs like cocaine and heroin affect apixaban. They could be potentially dangerous.

Injecting while taking apixaban will increase your risk of bleeding.

Talk to your doctor if you think you might use recreational drugs while taking apixaban.

Find out more about the side effects of some recreational drugs on the Frank website.

You can reduce your risk of having a blood clot by making changes to your lifestyle, such as:

• quitting smoking
• eating a healthy, balanced diet
• getting regular exercise
• keeping to a healthy weight or losing weight if you need to