When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to apixaban or you have active bleeding.

How to Use This Medicine:
Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• If you are not able to swallow the tablets whole, they may be crushed and mixed in water, 5% dextrose in water (D5W), apple juice, or applesauce. The crushed tablets may be mixed with 60 mL of water or D5W dose and given through a nasogastric tube (NGT).
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how apixaban works. Tell your doctor if you are using any of the following:
  
  • Carbamazepine, clarithromycin, itraconazole, ketoconazole, phenytoin, rifampin, ritonavir, St John's wort
  • Blood thinner (including clopidogrel, heparin, prasugrel, warfarin)
  • Medicine to treat depression
  • NSAID pain or arthritis medicine (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, bleeding problems, or an artificial heart valve.
• Do not stop using this medicine suddenly without asking your doctor. You might have a higher risk of stroke for a short time after you stop using this medicine.
• This medicine increases your risk for bleeding that can become serious if not controlled. You may also bruise easily, and it may take longer than usual for bleeding to stop.
• This medicine may increase your risk for blood clots in your spine or back if you undergo an epidural or spinal puncture. This could lead to paralysis. Tell your doctor if you ever had spine problems or back surgery.
• Tell any doctor or dentist who treats you that you are using this medicine. With your doctor's supervision, you may need to stop using this medicine several days before you have surgery or medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate, red or pink urine
• Chest pain, trouble breathing
• Coughing up blood, vomiting blood or material that looks like coffee grounds
• Numbness, tingling, or muscle weakness in your legs or feet
• Red or black, tarry stools
• Unusual bleeding, bruising, or weakness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088