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Eliquis (apixaban) is an anticoagulant that can reduce your risk of stroke and systemic embolism if you have nonvalvular atrial fibrillation. It also helps prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) if you’ve had hip or knee replacement surgery and treats DVT and PE while lowering recurrence risk.

Even though Eliquis is a newer medication, it has been shown to be more effective than older drugs. In clinical trials, Eliquis delivered better results in reducing VTE than enoxaparin and warfarin. The 2.5 mg twice daily and 5 mg once daily doses resulted in outcome rates of 9.0% and 11.3%, respectively, compared to 15.6% for enoxaparin and 26.6% for warfarin.

For safe and effective treatment, understanding the proper dosing schedule is essential. This guide will provide an overview of Eliquis dosing.

Quick Facts on Eliquis Dosing

    • Eliquis reduces recurrent DVT/PE risk with minimal bleeding, showing better outcomes than placebo.
    • After knee/hip surgery, take Eliquis at 2.5 mg twice daily for 12–35 days to prevent DVT.
    • If you forget to take a dose, take it as soon as you remember, but do not double up to make up for a missed dose
    • Compared to enoxaparin/warfarin, Eliquis reduces hospitalizations and shortens stay for DVT/PE patients.
    • Eliquis has a low major bleeding rate (0.2% for 2.5 mg), making it a safer option for DVT and PE prevention.

Eliquis Dosage Forms

Eliquis tablets come in the following strengths:

                        • 2.5 mg
                        • 5 mg
Eliquis dosing guide

Eliquis Dosage Chart

The Eliquis dosage can be adjusted based on your specific treatment needs. Here’s a detailed guide to help you understand the recommended dosing:

Indication Recommended Dose
Prevention of stroke and systemic embolism prevention in nonvalvular atrial fibrillation

5 mg orally twice daily

2.5 mg orally twice daily [if 80 years or older, weighs 60 kg (approximately 132.28 lbs) or less, or serum creatinine is higher than or equal to 1.5 mg/dL]
DVT prophylaxis after hip or knee replacement 2.5 mg orally twice daily
DVT and PE treatment 10 mg orally twice daily for 7 days, then 5 mg orally twice daily
Reduction of recurrent DVT and PE risk 2.5 mg orally twice daily

Eliquis Dosing Guide

Eliquis Dosing for Atrial Fibrillation

For atrial fibrillation, the standard Eliquis dose is 5 mg taken orally twice daily. However, the dose is adjusted to 2.5 mg twice daily if you exhibit at least two of the following characteristics:

    • age 80 or older
    • body weight 60 kg (approximately 132.28 lbs) or less
    • serum creatinine levels of 1.5 mg/dL or higher

This adjustment helps ensure the treatment is both safe and effective for you.

Research shows that Eliquis is generally well tolerated, with only about 6.3% of patients discontinuing treatment, primarily due to non-major bleeding events requiring medical intervention. Significantly fewer patients discontinue Eliquis compared to warfarin or aspirin, and nausea is reported in about 7% of users.

Eliquis Dosing for DVT Prevention After Hip or Knee Surgery

The recommended dose to prevent DVT after knee or hip replacement surgery is 2.5 mg of Eliquis twice daily, starting 12 to 24 hours after the surgery. If you had hip replacement surgery, the treatment will last for 35 days. For knee replacement surgery, the treatment duration is 12 days.

Eliquis has shown promising results in preventing DVT after knee replacement surgery. In clinical trials, Eliquis doses were associated with a 21–69% reduced risk of DVT compared to enoxaparin and a 53–82% reduction compared to warfarin, suggesting a wide therapeutic window. Eliquis was well-tolerated, with minimal major bleeding events, and there were no significant differences in wound complications or infections compared to other treatments.

Eliquis Dosing for DVT and PE Treatment

The initial recommended dose of Eliquis for DVT and PE treatment is 10 mg twice daily for the first 7 days. Afterward, your dose will be reduced to 5 mg twice daily. If you’ve been treated for DVT or PE for at least 6 months, your maintenance dose will be 2.5 mg twice daily.

Eliquis significantly reduced all-cause hospitalizations compared to enoxaparin/warfarin in patients treated for DVT and PE. In a study of 5,365 patients, only 5.72% of those on Eliquis were hospitalized, compared to 7.07% in the enoxaparin/warfarin group. The hospitalization rate within the first 30 days was also lower for Eliquis (2.28%) compared to enoxaparin/warfarin (3.35%). The average hospital stay was shorter for patients on Eliquis, with a mean stay of 0.57 days versus 1.01 days for those on enoxaparin/warfarin.

Eliquis Dosing for DVT and PE Risk Reduction

To lower the risk of recurrent DVT and PE, the recommended dose of Eliquis is 2.5 mg taken orally twice daily after 6 months of initial treatment. 

A research involving 2,486 patients showed that Eliquis significantly reduced the risk of recurrent DVT and PE compared to a placebo. Of those receiving 2.5 mg of Eliquis, only 1.7% experienced symptomatic recurrent venous thromboembolism or death, compared to 8.8% in the placebo group. The 5 mg dose of Eliquis had similar results, with 1.7% recurrence rates. The rate of major bleeding was low in both Eliquis groups (0.2% for 2.5 mg and 0.1% for 5 mg), significantly lower than in the placebo group (0.5%).

A 75-year-old Reddit user shared that he was prescribed Eliquis after experiencing DVT and is now pain-free, able to walk 1-2 miles a day.

Reducing Eliquis Dose?
byu/HDee75 inClotSurvivors

Eliquis Missed Dose 

If you miss a dose of Eliquis, take it as soon as you remember on the same day. Then, continue with your regular twice-daily schedule. Do not take two doses at once to make up for the missed dose.

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Final Insights

Your Eliquis dosing depends on your treatment plan and factors like age, weight, and kidney function. It’s highly effective for preventing and treating DVT and PE and reducing recurrence risk when taken at 2.5 mg twice daily after six months of initial therapy. Compared to alternatives like enoxaparin and warfarin, Eliquis often leads to fewer and shorter hospital stays. It’s generally well-tolerated with a low risk of severe bleeding. Be sure to consult your healthcare provider to determine the right dosage and ensure it’s safe and effective for you.

Frquently Asked Questions

Eliquis is most effective when you take it twice daily to achieve optimal treatment benefits. Taking it once daily may reduce its effectiveness.

No, Eliquis will not dissolve an existing blood clot. Instead, it works by preventing the formation of new clots and stopping existing ones from getting larger. If a blood clot needs to be dissolved quickly, thrombolytic (clot-busting) medications or other medical interventions may be necessary, depending on the situation. Always consult a healthcare provider for the best course of action.

The length of time you can safely take Eliquis depends on your medical condition and your healthcare provider’s recommendation. Eliquis is often prescribed for long-term or even lifelong use, particularly for conditions such as atrial fibrillation or after recurrent DVT or PE.

Drinking alcohol while on Eliquis may further raise your risk of bleeding, as both can affect blood clotting. It’s best to avoid alcohol consumption while taking Eliquis.

To switch, stop taking Xarelto and take your first dose of Eliquis when the next dose of Xarelto would have been scheduled. Be sure to consult your doctor before making any changes to your medication.

Avoid supplements that may increase the risk of bleeding, such as ginkgo biloba, vitamin E, and fish oil. Additionally, be cautious with supplements like St. John’s wort, as they can reduce the effectiveness of Eliquis and increase your risk of blood clots.

Bleeding is the most common side effect of Eliquis, which may include symptoms such as bruising, blood in the urine, or bleeding gums, among others.

To switch from Warfarin to Eliquis, you should stop taking Warfarin when your INR (International Normalized Ratio) is below 2.0 and then start Eliquis. This ensures your blood clotting levels are safe before transitioning to Eliquis. Always consult your doctor before making the switch.

Sources

U.S. Food and Drug Administration. (2012). Eliquis (apixaban) label. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202155s000lbl.pdf

Bristol-Myers Squibb. (n.d.). Eliquis (apixaban) prescribing information. Retrieved from https://packageinserts.bms.com/pi/pi_eliquis.pdf

Alexander, J. H., & Duffy, C. (2022). Apixaban for the prevention of adverse outcomes in patients with atrial fibrillation. American Journal of Cardiology, 210, 69-75. https://doi.org/10.1016/j.amjcard.2022.05.031

Rhyner, C., & Karp, I. (2014). Managing patients on anticoagulants: A guide for family physicians. American Family Physician, 89(8), 672-678. Retrieved from https://www.aafp.org/pubs/afp/issues/2014/0415/p672.html

Keshtkar, A., & Arian, M. (2020). The efficacy of apixaban in patients with atrial fibrillation. Journal of Thrombosis and Thrombolysis, 50(1), 156-172. https://doi.org/10.1080/17474086.2020.1711731

Patel, M. R., Mahaffey, K. W., Garg, J., et al. (2015). Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. Journal of the American Heart Association, 4(7), e002340. https://doi.org/10.1161/jaha.115.002340

Connolly, S. J., Ezekowitz, M. D., Yusuf, S., et al. (2011). Dabigatran versus warfarin in patients with atrial fibrillation. New England Journal of Medicine, 361, 1139-1151. https://doi.org/10.1056/NEJMoa1207541

Anticoagulation Forum. (2019). Anticoagulation recommendations for apixaban. Retrieved from https://acforum-excellence.org/Resource-Center/resource_files/1322-2019-03-08-101259.pdf

Drugs.com. (2022). What foods to avoid with Eliquis? Retrieved from https://www.drugs.com/medical-answers/what-foods-avoid-eliquis-3577939/