A direct oral anticoagulant that blocks clotting factor Xa, preventing strokes in atrial fibrillation and treating deep vein thrombosis and pulmonary embolism without routine blood monitoring.
Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.
What it is used for
Preventing stroke in atrial fibrillation (first choice over warfarin for most)
Treating and preventing deep vein thrombosis and pulmonary embolism
Preventing clots after hip and knee replacement
Not used for mechanical heart valves or antiphospholipid syndrome (warfarin remains)
How it works in the body
Binds directly to activated factor X, the enzyme at the junction of the clotting cascade that converts prothrombin to thrombin. Less thrombin means less fibrin, so clots that form in the slow-flowing left atrial appendage or leg veins are prevented or stopped from growing. Unlike warfarin the effect is predictable, starts within hours, needs no blood-level monitoring and is little affected by diet.
Common side effects
Bruising, nosebleeds, bleeding gums, heavier periods
Nausea, anaemia
Serious: seek help
Major bleeding: gastrointestinal, intracranial (about half the rate of warfarin), retroperitoneal
Bleeding after trauma or surgery; reversal agents (andexanet, idarucizumab for dabigatran) exist but are limited
Spinal haematoma with epidural anaesthesia
Cautions and interactions
Dose reduced with kidney impairment, low weight, age over 80 (apixaban), and some interacting drugs
Avoid NSAIDs and aspirin unless specifically advised; alcohol in moderation
Stop 24-72 hours before surgery depending on bleeding risk and kidney function
Missed doses matter because the effect wears off quickly; do not double up
Interactions
Check interactions
Taking Apixaban and DOACs with other medicines? Add them to the checker to see what the official sources say about each pair: the mechanism, general management and monitoring, never a bare "safe".
Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.
BNF: Apixaban interactions (increased risk of bleeding); NHS apixaban: only if prescribed
Sources
NHS: Aspirin(Low-dose aspirin · Taking it with other medicines and herbal supplements)UK BNF: Apixaban interactions(Interactions)UK NHS: Apixaban(Taking it with other medicines and herbal supplements · Medicines that interact with apixaban)UK
Review
Facts checked against the cited sources; not yet clinically reviewed · last reviewed 12 September 2026
Therapeutic duplication. Two anticoagulants together (for example warfarin with a DOAC outside a supervised switch) multiply bleeding risk and are avoided. UK
Medicines that share the class of Apixaban and DOACs. They are separate medicines with their own licences, doses and interactions, not alternative names for Apixaban and DOACs.
Medicines often discussed alongside Apixaban and DOACs: used together, compared with it, or acting on the same problem by a different route.
Educational content. Anatomy Nexus provides medical education and does not replace professional medical advice, diagnosis, treatment, prescribing or pharmacist review. Doses, choices and monitoring are decided by a prescriber for an individual; never start, stop or change a medicine on the basis of this page.
