What Is Apixaban?

Apixaban (brand name Eliquis) is a prescription blood thinner in the class of Direct Oral Anticoagulants (DOACs). It's used to prevent stroke and blood clots in patients with atrial fibrillation, treat deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevent blood clots after hip or knee replacement surgery. Unlike older blood thinners like Warfarin, Apixaban doesn't require regular blood monitoring or strict dietary restrictions.

How does Apixaban work?

Apixaban works by selectively blocking Factor Xa, a key enzyme in the blood clotting cascade. By inhibiting Factor Xa, it prevents the conversion of prothrombin to thrombin, which reduces the formation of blood clots without completely stopping the body's ability to clot when necessary. This targeted approach makes it effective at preventing harmful clots while minimizing bleeding risk compared to older anticoagulants.

What doses are available for Apixaban?

• 2.5 mg oral tablets — for reduced dosing in atrial fibrillation patients or DVT prophylaxis after hip/knee surgery
• 5 mg oral tablets — standard dose for most indications including atrial fibrillation, DVT, and PE treatment

How hard is it to find Apixaban in stock?

Generic Apixaban became available in late 2024/early 2025 after patent settlements, creating initial supply disruptions as pharmacies transitioned from brand Eliquis to multiple generic manufacturers. As of 2026, supply is stabilizing but some patients still report difficulty finding specific generic formulations at their local pharmacy. Brand Eliquis remains consistently available but more expensive.

Who Can Prescribe Apixaban?

Apixaban can be prescribed by various specialists and primary care providers, including cardiologists, hematologists, internal medicine doctors, family medicine physicians, vascular medicine specialists, and emergency medicine doctors. Orthopedic surgeons also commonly prescribe it for post-surgical blood clot prevention. Many providers are comfortable prescribing DOACs like Apixaban due to their predictable effects and reduced monitoring requirements.

Is Apixaban a controlled substance?

No, Apixaban is not a controlled substance and has no DEA schedule classification. It's a prescription medication that requires a doctor's order but doesn't have the additional regulatory restrictions that apply to controlled substances like opioids or stimulants.

Common Side Effects of Apixaban

• Bleeding — Minor bruising, nosebleeds, bleeding gums, prolonged bleeding from cuts
• Nausea — Stomach upset, especially when starting treatment
• Anemia — Low red blood cell count from minor bleeding
• Easy bruising — Increased susceptibility to bruises from minor trauma
• Heavy menstrual bleeding — More pronounced periods in women

Alternative Medications to Apixaban

• Rivaroxaban (Xarelto) — Another Factor Xa inhibitor with once-daily dosing for most indications
• Warfarin (Coumadin) — Older anticoagulant requiring regular blood monitoring but much less expensive
• Edoxaban (Savaysa) — Factor Xa inhibitor with once-daily dosing, requires initial injectable anticoagulation for blood clots
• Dabigatran (Pradaxa) — Direct thrombin inhibitor with twice-daily dosing and a specific reversal agent available

Drug Interactions with Apixaban

• Strong CYP3A4 inhibitors — Ketoconazole, Ritonavir, Clarithromycin increase Apixaban levels, requiring dose reduction
• Strong CYP3A4 inducers — Rifampin, Carbamazepine, St. John's Wort decrease effectiveness, should be avoided
• Other blood thinners — Warfarin, Heparin, Enoxaparin significantly increase bleeding risk
• NSAIDs — Ibuprofen, Naproxen, Aspirin increase bleeding risk when used together
• Antidepressants — SSRIs and SNRIs may modestly increase bleeding risk

Final Thoughts on Apixaban

Apixaban represents a significant advance in anticoagulation therapy, offering effective clot prevention without the dietary restrictions and monitoring requirements of older medications like Warfarin. The recent availability of generic versions has made it more affordable, though supply transitions may cause temporary availability issues at some pharmacies. Patients should work closely with their healthcare providers to determine if Apixaban is right for their condition and to monitor for any signs of bleeding or other side effects. If you're having trouble finding Apixaban in stock, Medfinder can help locate pharmacies with current inventory.