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It is crucial to follow specific safety guidelines when taking apixaban (Eliquis) to ensure your health and safety. The following points highlight important risks and precautions:

• Do Not Discontinue Abruptly: Stopping apixaban without medical advice can increase the risk of forming serious blood clots, such as strokes or clots in the legs or lungs. Always consult your doctor if you are considering stopping the medication, as they may suggest an alternative blood-thinning treatment.

• Seek Immediate Medical Attention: If you experience symptoms like weakness on one side of the body, speech difficulties, sudden vision changes, confusion, chest pain, breathing trouble, or leg pain/swelling, get medical help without delay.

• Spinal Procedure Risks: Apixaban can increase the risk of bleeding around the spinal cord after specific spinal procedures, potentially leading to long-term or permanent paralysis. Discuss the benefits and risks with your doctor if you are undergoing a spinal procedure, especially if you have a history of spinal surgery or conditions affecting the spine.

• Increased Bleeding Risk: This medication can elevate your risk of bleeding, particularly if you are on other medications that contribute to bleeding, like NSAIDs or other anticoagulants. In the event of a serious bleed, Andexxa (andexanet alfa) might be administered to counteract the effects of apixaban. Report any falls, head injuries, or signs of internal bleeding, such as dark stools, to your healthcare provider immediately.

• Antiphospholipid Syndrome: Apixaban is not recommended for individuals with antiphospholipid syndrome, as it has not proven effective for this condition.

• Contraindications: Do not use apixaban if you have active bleeding or a severe allergic reaction to the medication or any other direct oral anticoagulant (DOAC).

Always consult your healthcare provider for personalized advice and to ensure safe use of apixaban.

When taking this medication, some individuals may experience mild side effects such as nausea, easy bruising, or minor bleeding, which can include nosebleeds and bleeding from cuts or gums. These effects are usually not serious, but if they persist or worsen, it is advisable to consult your healthcare provider.

However, it is important to be aware of more serious side effects that require immediate medical attention. Serious bleeding can occur, manifesting as frequent or persistent nosebleeds, unusual tiredness, prolonged bleeding from cuts, heavy menstrual flow, pink or dark urine, coughing up blood, vomiting that resembles coffee grounds, severe headaches, dizziness, or fainting. Additionally, you may notice bloody, black, or tarry stools, or difficulty swallowing, which are indicators of serious bleeding.

Rare but very serious side effects include signs of a stroke, such as sudden numbness or weakness on one side of the body, confusion, trouble speaking, or dizziness. Signs of blood clots, like swelling or redness in the arms or legs, trouble breathing, chest pain, or an irregular heartbeat, also require urgent medical care. If you experience symptoms of a serious allergic reaction, such as rash, itching, swelling of the face, tongue, or throat, severe dizziness, or trouble breathing, seek medical help immediately.

This summary does not cover all possible side effects. If you notice any other unusual effects, contact your healthcare provider for guidance.

When using apixaban, be aware that it can interact with various medications and supplements. It's essential to inform your healthcare provider about all medications and supplements you're taking, including prescription, over-the-counter drugs, vitamins, and herbal products.

Certain medications are not recommended to be used with apixaban. For instance, defibrotide should generally be avoided. However, there are instances where the combination of apixaban with other drugs may be necessary, although it is usually not recommended. If your doctor prescribes them together, they might adjust the dosage or frequency. Such medications include abametapir, abciximab, aceclofenac, Aspirin, Clopidogrel, and many others, especially those that affect blood clotting and bleeding risk.

Apixaban's effectiveness can be altered by other drugs that impact its removal from the body. Medications like certain antifungals (e.g., Itraconazole, Ketoconazole), HIV protease inhibitors, rifamycins, and St. John's wort are examples of this. Additionally, drugs for seizures, such as Carbamazepine and Phenytoin, can also interact.

Aspirin can elevate bleeding risk when taken with apixaban. However, if prescribed low-dose aspirin to prevent heart issues, continue as directed by your doctor unless advised otherwise.

Lastly, certain drugs may heighten side effects risks when used with apixaban, yet might be necessary for treatment. In such cases, your doctor will adjust the treatment plan. These include Amiodarone, Cyclosporine, and Erythromycin. Always follow your healthcare provider's guidance on medication use.