Venous thromboembolism is a potentially fatal complication in surgical patients and also in acutely ill non-surgical patients. Patients undergoing orthopedic surgery (hip or knee replacement) are at a high risk of developing postoperative venous thromboembolic complications. In this regard, correct anticoagulation is essential in order to decrease patient morbidity and mortality.
Eliquis reversibly and selectively inhibits the activation site of factor Xa, a trypsin-like serine protease which is the final enzyme in the coagulation cascade, being responsible for fibrin clot formation.
Thus, this drug has been used for its antithrombotic and anticoagulant effects to prevent thrombotic complications in acutely ill non-surgical patients and following knee or hip replacement surgery, as well as in patients with acute coronary syndrome (ACS) and in cases of atrial fibrillation (AF).
This medicine is available in the market as tablet dosage form and you can get this medicine only with your doctor's prescription.
2 What to Know Before Using
Before using Eliquis, you must know all about the risks and complications associated with it. The suitable drug therapy is usually chosen by a doctor with the active participation of the patient.
There are some important factors such as drug interactions, the presence of any metabolic impairment, history of hypersensitivity reaction, pregnancy, lactation etc. which may alter the desired therapeutic effects of a medicine.
Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects. If you have had any allergic reactions to any medicine then you must tell your doctor about that. The use of apixaban is contraindicated in those with known hypersensitivity to this drug or any of the ingredients of the formulation.
Make sure you inform your doctor if you have any other medical problems, especially:
Active bleeding or history of bleeding problems
Catheter insertion in the spine
Prosthetic (artificial) heart valve—this drug should not be used in patients with these conditions.
Recent surgery—caution should be exercised because the risk of bleeding may be increased.
Liver and/or kidney disease
Because of drug-drug interactions, certain medicines should not be used along with this medicine. It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects.
Besides, if you are taking another medicine (e.g. heparin, warfarin) for the treatment of your current medical problem, you should inform your doctor so that he/she can give you very specific instructions about how to switch to apixaban.
Animal reproduction studies have not shown any adverse effect on the fetus and there are no adequate and well-controlled studies in humans. But animal reproduction studies are not always predictive of human response. Thus, this drug should be used during pregnancy only if clearly needed.
Besides, caution should be exercised when used in lactating women because there are no adequate studies in women for determining infant risk when using this medication during breastfeeding.
3 Proper Usage
To use Eliquis properly, you must follow all instructions given by your doctor. The dosage schedule and the duration of drug therapy should be individualized and determined based on the physician’s advice.
The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well; however, the dose and duration of this drug therapy for different indications are listed below:
Adults with 2 of the following characteristics: 80 years of age and older, the body weight of 60 kg or less, or kidney problems—2.5 mg two times a day.
Children—use and dose must be determined by your doctor.
For treatment of deep venous thrombosis and pulmonary embolism:
Adults—initially, 10 mg two times a day, for the first 7 days. Then, your doctor may give you 5 mg two times a day.
Children—use and dose must be determined by your doctor.
If you miss a dose of this medicine, take it as soon as possible. But, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. But you should not use this drug in larger amounts, more often, or for a longer time than your doctor ordered.
Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed of by an appropriate way.
4 Precautions to Take
Before using Eliquis, there are some precautions you must take. Firstly, regular visits to your doctor are recommended to check that this medicine is working properly or not.
Additionally, the following guidelines should be followed to prevent unwanted complications as well as for the better prognosis of the patients:
This medicine may cause a serious type of allergic reaction called anaphylaxis that can be life-threatening and requires immediate medical attention. If you notice any symptom suggesting allergic reactions that may be rash, itching, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth, check with your doctor immediately.
The use of this drug needs to be stopped for several days before having any surgery and/or dental procedures.
You should not stop using this medicine without asking your doctor. You might have a higher risk of stroke after you stop using this medicine.
You may bleed and bruise more easily while you are using this medicine. You should stay away from rough sports or other situations where you could be bruised, cut, or injured. Be careful when using sharp objects, including razors and fingernail clippers. It is advised to brush your teeth gently and avoid picking your nose. If you need to blow your nose, blow it gently.
Check with your doctor right away if you have any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, headache, dizziness, or weakness, pain, swelling, or discomfort in a joint, pinpoint red spots on your skin, unusual nosebleeds, or unusual vaginal bleeding that is heavier than normal. These may be signs of bleeding problems.
This medicine may increase the risk of blood clot in the spine or epidural area, which may lead to long-term or permanent paralysis. This is more likely to occur if you have an epidural catheter placed in your back, are taking NSAID or blood clotting medicine, a history of repeated epidural punctures or problems with your spine, or have had surgery on your spine.
If you have tingling, numbness, or muscle weakness, especially in your legs and feet, check with your doctor right away.
Further, you should not take other prescription or nonprescription (over-the-counter) medicines and herbal or vitamin supplements unless they have been discussed with your doctor.
5 Potential Side Effects
As with many medications, there are several potential side effects associated with Eliquis. These side effects usually go away during the treatment episode as your body adjusts to the medicine. Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.
Sometimes you may need to consult with the doctor if you notice any of the following toxic effects:
Bleeding (most common) – it may be in various forms like vomiting of blood, nose bleeding, bruising or purple areas on the skin, blood in stool and/or urine
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