The Primary Uses of Eliquis (Apixaban)
Eliquis is a direct-acting oral anticoagulant (DOAC) prescribed for several key medical conditions where blood clots pose a significant risk. It is primarily used to prevent blood clots from forming.
Nonvalvular Atrial Fibrillation (AFib)
Atrial fibrillation (AFib), an irregular heartbeat, can lead to blood clots that may cause a stroke or systemic embolism. Eliquis is prescribed to reduce this risk in adults with AFib not related to a heart valve problem. Studies show Eliquis is effective in reducing stroke and embolism risk compared to warfarin, with a lower rate of major bleeding.
Treatment of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)
Eliquis is approved for treating existing deep vein thrombosis (DVT) and pulmonary embolism (PE), as well as reducing the chance of these dangerous clots happening again. DVT is a clot in a deep vein, often in the leg, and PE occurs if a DVT clot travels to the lungs. Treatment for DVT/PE typically involves an initial treatment phase followed by a maintenance phase for ongoing prevention.
Prophylaxis Following Hip or Knee Replacement Surgery
To prevent blood clots after hip or knee replacement, Eliquis may be prescribed. This helps reduce the risk of DVT and subsequent PE. The duration of treatment is typically for a specific period following surgery.
How Eliquis Works: The Mechanism of a Factor Xa Inhibitor
Eliquis is a direct Factor Xa inhibitor. It works by blocking Factor Xa, an enzyme crucial for the blood clotting process. By inhibiting Factor Xa, Eliquis prevents the formation of blood clots. It is typically taken twice daily to maintain consistent blood levels and prevent clotting.
Administration
Eliquis is an oral medication with administration instructions that vary depending on the condition and patient factors. Adherence to the prescribed regimen is crucial for effectiveness and safety.
Eliquis tablets can be crushed and mixed with water, apple juice, or applesauce for immediate use if swallowing is difficult.
Important Considerations and Potential Risks
As a blood thinner, Eliquis has potential risks, primarily bleeding. Bleeding can range from minor to severe and life-threatening.
Signs of potential bleeding issues include:
- Unusual bruising or prolonged bleeding.
- Frequent nosebleeds or bleeding gums.
- Pink, red, or brown urine.
- Red or black, tarry stools.
- Coughing up blood.
- Vomiting blood or material resembling coffee grounds.
- Unexpected pain or swelling.
- Severe headaches, dizziness, or weakness.
Spinal or Epidural Hematoma
Patients taking Eliquis who have spinal or epidural procedures face a risk of a blood clot forming around the spine, potentially causing paralysis. This risk is elevated with certain medical conditions or concurrent medications.
Premature Discontinuation
Stopping Eliquis without a replacement anticoagulant increases the risk of blood clots and stroke. Do not stop taking Eliquis without consulting a healthcare provider. If Eliquis needs to be paused for a procedure, follow your doctor's specific instructions.
Comparison: Eliquis vs. Warfarin
Eliquis differs from the older anticoagulant warfarin in several ways.
| Feature | Eliquis (Apixaban) | Warfarin |
|---|---|---|
| Mechanism | Directly inhibits Factor Xa | Vitamin K antagonist |
| Monitoring | No routine blood tests needed | Requires regular INR blood testing |
| Dietary Restrictions | None | Consistent Vitamin K intake required |
| Drug Interactions | Fewer known interactions | Many drug and supplement interactions |
| Onset of Action | Fast (hours) | Slow (days) |
| Reversal Agent | Andexanet alfa available | Reversible with Vitamin K |
| Cost | Brand name, potentially higher cost | Generic available, lower cost |
Conclusion
Eliquis is an effective anticoagulant used to prevent stroke in nonvalvular AFib, treat and prevent DVT/PE, and reduce clot risk after joint replacement surgery. As a Factor Xa inhibitor, it offers predictable results without the need for regular monitoring or dietary restrictions like warfarin. While bleeding is the main risk, understanding the signs and communicating with your doctor are crucial for safe use. Always consult a healthcare professional to determine if Eliquis is suitable for you.
