From the Guidelines
Eliquis (apixaban) can be taken with or without food, as its absorption is not significantly affected by food intake. This anticoagulant medication does not have specific food requirements, making it convenient for patients to take at their prescribed times regardless of meals. The effectiveness of Eliquis remains consistent whether taken on an empty stomach or with food, as stated in the study 1. Patients should follow their healthcare provider's instructions regarding the timing of doses (typically twice daily) and take the medication at approximately the same times each day to maintain consistent blood levels.
- It's essential to take Eliquis exactly as prescribed without skipping doses, as this medication helps prevent blood clots and reduces the risk of stroke in people with certain conditions.
- If a dose is missed, it should be taken as soon as remembered on the same day, but never take a double dose to make up for a missed one.
- Always swallow the tablet whole with water, and do not crush or chew it unless specifically instructed by the healthcare provider. The most recent and highest quality study 1 supports the idea that apixaban can be taken with or without food, and its pharmacokinetic characteristics are not significantly affected by food intake.
From the FDA Drug Label
Food does not affect the bioavailability of apixaban.
- Eliquis (apixaban) does not need to be taken with food.
- The bioavailability of apixaban is not affected by food consumption 2.
From the Research
Administration of Eliquis
- Eliquis (apixaban) can be taken with or without food, as food does not have a clinically meaningful impact on its bioavailability 3.
- The absolute oral bioavailability of apixaban is approximately 50%, and its exposure increases dose proportionally for oral doses up to 10 mg 3.
- Apixaban is rapidly absorbed, with maximum concentration occurring 3-4 hours after oral administration, and has a half-life of approximately 12 hours 3.
Interactions with Other Medications
- Apixaban has limited clinically relevant interactions with most commonly prescribed medications, allowing for fixed dosages without the need for therapeutic drug monitoring 3.
- However, concomitant administration of strong p-glycoprotein inhibitors and statins may require dose adjustment, as it can lead to increased apixaban concentrations 4.
- Providers should consider utilizing the apixaban anti-Xa assay or comparative heparin anti-Xa assay to determine if patients require dose reduction to decrease adverse events in high-risk patients prescribed apixaban and concomitant p-glycoprotein and CYP3A4 inhibitors 4.
Special Populations
- Apixaban can be safely used in patients with end-stage kidney disease (ESKD), and is associated with a lower risk of bleeding compared to warfarin 5, 6.
- Multiple studies suggest that apixaban is possibly associated with a lower prevalence of bleeding and thromboembolic events compared with warfarin therapy in patients with ESKD 6.