Apixaban (Eliquis) to Prevent Strokes
Apixaban was approved by the US Food and Drug Administration (FDA) based on the results of the international ARISTOTLE and AVERROES studies. In ARISTOTLE, 18,201 participants with atrial fibrillation and at least one other stroke risk were given either apixaban or warfarin. Apixaban reduced the risk of stroke or blood clots by 21 percent compared to warfarin, with significantly less major bleeding and fewer deaths.2
In the AVERROES study, 5,598 participants who had atrial fibrillation and couldn’t take warfarin received either apixaban or aspirin. Participants receiving apixaban had a lower risk of stroke and blood clots than those on aspirin, with no increased risk of major bleeding.3
How It Works
Apixaban is a direct factor Xa (pronounced “10 a”) inhibitor. It disrupts factor Xa, which is needed to convert a protein called fibrinogen to fibrin, the major component of blood clots. By disrupting that process, apixaban reduces the risk of blood clots and stroke.
As a direct factor Xa inhibitor, apixaban is a Direct (or direct-acting) Oral Anticoagulant (DOAC).
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The recommended dose for apixaban is 5 mg twice a day for most people with afib. The recommended dose is 2.5 mg twice a day for those who meet two of these three criteria: age of 80 years or over, weight of 60 kg (132 pounds) or under, or have kidney disease.4,5,6,7,8
In 2019, apixaban recommendations were revised so afib patients with end-stage kidney disease and on dialysis could take 5 mg twice a day. For those with end-stage kidney disease and on dialysis who are age 80 or over, or with a weight of 60 kg (132 pounds) or under, the recommended dose of apixaban is 2.5 mg twice a day.8
To learn more about who can and cannot take DOACs and what to know if you do, see Direct Oral Anticoagulants (DOACs).
What to Know If You Take Apixaban
Here are things to know that are specific to taking apixaban.
- Apixaban costs more than warfarin, so you may have a higher out-of-pocket cost.
- If you need emergency surgery or have severe bleeding, your doctor can use a reversal agent to quickly stop the anti-clotting effects of apixaban. The FDA approved Andexxa®, the first reversal agent for apixaban, in May of 2018.9
- See What to Know If You Take a DOAC for things everyone on a DOAC should know, including potential medication and supplement interactions, signs of unusual bleeding, and what to know if you are asked to stop your apixaban for a procedure or surgery.
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