m odern medical research has (and continues to) produce medications such as ELIQUIS (Apixaban) that help improve your health and extend your quality and length of life. Despite the obvious positive effect of medications, some can cause dangerous side effects, which lead to many injuries to you, the consumer. If you are a victim of a dangerous drug, you can bring a product liability lawsuit against the pharmaceutical company that produces it for its failure to manufacture the drug properly.
What is ELIQUIS?
e LIQUIS (Apixaban) is an anticoagulant that blocks certain clotting proteins from forming in your blood. It is used in the prevention of serious blood clots that form as a result of atrial fibrillation (irregular heartbeat) or after knee or hip replacement surgery. In the case of atrial fibrillation, part of your heart fails to beat the way it is supposed to do. This anomaly can lead to the formation of blood clots that can travel to other areas of your body such as your legs or lungs. The clots can also increase your risk for stroke.
Apixaban medication is also used in the treatment of certain blood clots such as pulmonary embolus (PE) or deep vein thrombosis (DVT). It also prevents the above clots from forming again. Despite its wide use as an anticoagulant, Apixaban has some serious side effects that you have to watch out for when using it.
Ingredients in ELIQUIS
e LIQUIS tablets are available if you prefer oral administration of the drug. The tablets come in strengths of 5mg and 2.5mg of apixaban. It has the following active ingredients:
- Anhydrous lactose
- Microcrystalline cellulose
- Sodium lauryl sulfate
- Magnesium stearate
- Croscarmellose sodium
The tablets’ film coating contains:
- Lactose monohydrate
- Titanium dioxide
- Yellow iron oxide (2.5mg tablets)
- Red iron oxide (5mg tablets)
How to Use ELIQUIS (Apixaban)
i t’s, generally, advisable to read ELIQUIS’ medication guide or patient information leaflet, if available, before you start taking apixaban – as well as every time you get a refill. You can also talk to your doctor or pharmacist if you have any queries or concern.
Apixaban is taken by mouth and as directed by your doctor, usually twice daily with or without food. If you are unable to swallow the tablet whole, you have the option of cutting it into two or crushing it completely and then mix it with water or juice. The dosage is based on factors such as your medical condition, age, response to treatment, kidney function, or other medications that you are taking. Ergo, you must disclose to your doctor any other products you are using such as herbal products as well as prescription and nonprescription drugs.
When using Apixaban to prevent the formation of blood clots after undergoing surgery, you should know that the length of your prescription is based on your surgery type. You should always use this drug as prescribed by your doctor and never discontinue its use without consulting. Some of the side effects that you may experience while taking Apixaban may worsen when its use is suddenly stopped, so, do not run out of your prescription.
Precautions when Using ELIQUIS
b efore taking Apixaban, you must first reveal to your pharmacist or doctor any allergies that you have since it may contain inactive ingredients that can cause allergic reactions. You also need to reveal your medical history to your doctor or pharmacist especially if you have any of the following: kidney disease, liver disease; bleeding conditions such as brain bleeds or bleeding in your stomach/intestines; blood disorders such as hemophilia, anemia, or thrombocytopenia; stroke; frequent injuries and falls; as well as if you have undergone recent major surgery or injury.
Before having surgery or undergoing any dental and medical procedure such as a spinal puncture or epidural anesthesia, you need to tell your primary caregiver that you are taking ELIQUIS (apixaban) as well as any other medical products that you are using such as herbal products or prescription and nonprescription medication. This is because your doctor may ask you to stop taking this drug for some period before your surgery.
Apixaban may cause stomach bleeding, which is exacerbated by the daily use of alcohol. Ergo, you need to limit your intake of alcohol during this period or, at least, ask your doctor how much alcohol you can safely consume. Also, you need to lower your chances of getting injured or cut when handling sharp objects like nail cutters, safety razors, and shavers. During pregnancy, Apixaban should only be taken when it is absolutely needed. It is still unclear if the medication passes into breast milk. Thus, you should consult your doctor before you breastfeed.
The Side Effects of ELIQUIS
l ike most medicines, ELIQUIS (Apixaban) has side effects that affect different people in different ways; though, many people who use this medication do not suffer serious effects. If your doctor prescribes you this medication, it is because they have considered all its potential effects and decided that the benefit to your health is greater than the risk of possible side effects.
You may experience nausea, minor bleeding such as from cuts or nosebleeds, and easy bruising after using Apixaban. However, if one or more of these symptoms persist, you should report it to your doctor as soon as possible. Apixaban can, also, lead to serious bleeding if its use affects your blood clotting proteins. You should tell your doctor if you experience any signs of excessive bleeding that includes:
- Unusual swelling, discomfort, or pain
- Unusual bruising
- Prolonged bleeding from your gums and cuts
- Frequent and persistent nosebleeds
- Pink or dark urine
- Unusually heavy or prolonged menstrual flow
- Coughing up blood
- Bloody vomit
- Severe headaches
- Dizziness and fainting
- Difficulty swallowing
- Unusual weakness or tiredness that is persistent
- Passing bloody, tarry stool
Other possible serious side effects of Apixaban include vision changes, slurred speech, confusion, and weakness on one side of your body. In rare cases, you may experience severe allergic reactions that include a rash; severe dizziness; troubled breathing; as well as itching or swelling of your face, throat, or tongue. As this is not a complete list of all possible side effects, you should contact your doctor if, and when, you notice any other effects after using Apixaban.
- Thrombotic Events from Premature Discontinuation
The premature discontinuation of ELIQUIS medication increases your risk of suffering thrombotic events. This is true for any oral anticoagulant. If anticoagulation using ELIQUIS is discontinued for any reason other than completion of therapy or pathological bleeding, you should consider covering the remainder of your dosage using another anticoagulant as advised by your doctor.
- Spinal/ Epidural Hematoma
Spinal or epidural hematomas may occur in patients using ELIQUIS who are undergoing spinal puncture or receiving neuraxial anesthesia. Such hematomas may cause permanent of long-term paralysis. Therefore, your physician should consider these risks and explain them to you when scheduling your spinal procedures. Factors that can increase your risk of developing spinal or epidural hematomas include:
- The use of indwelling epidural catheters
- The concomitant use of drugs that affect hemostasis including other anticoagulants and nonsteroidal anti-inflammatory drugs referred to as NSAIDs
- A history of repeated or traumatic spinal or epidural punctures
- A history of spinal surgery or deformity
How ELIQUIS Interacts with Other Medications
d rug interactions can increase the risk of suffering serious side effects or affect how your medications work. Therefore, it is important that you know about all possible drug interactions of ELIQUIS or any other medication you are using beforehand.
To do this, you need to keep a list of the medical products you are presently using, which includes both prescription and non-prescription medications as well as any other herbal products. Share the list with your doctor and pharmacist so that they can take all possible drug interactions into consideration. Also, do not start or stop taking your medication or change the dosage without the approval of your doctor.
Some of the medical products that may interact with ELIQUIS are:
- Clopidogrel and other antiplatelet drugs that can cause bleeding
- Blood thinners such as enoxaparin and warfarin
- Certain antidepressants such as fluoxetine (SSRIs) and venlafaxine/desvenlafaxine (SNRIs)
There are some medications that can affect how your body removes apixaban from its system, which essentially affects how ELIQUIS works. Examples include some azole antifungals such as ketoconazole, itraconazole, and posaconazole. Other drugs that affect apixaban removal are:
- HIV protease inhibitors such as ritonavir and lopinavir
- Rifamycins like rifabutin
- Drugs commonly used to treat seizures such as phenytoin and carbamazepine
- St. John’s Wort
Levels of Interactions
Medications that cause severe interactions with ELIQUIS are:
- Antiplatelet, anticoagulant, thrombolytic/alipogene tiparvovec
- Antiplatelets, anticoagulants/mifepristone
Interactions that cause serious reactions are:
- Apixaban, Rivaroxaban/PGP with strong CYP 3A4 inducers
- Apixaban, Edoxaban, Betrixaban, Rivaroxaban/NSAIDS
- Apixaban, Antiplatelets, aspirin (>100mg)
- Apixaban/P-GP with strong CYP3A4 inhibitors
- Apixaban/Anticoagulant, Thrombolytic
- Anticoagulant, Thrombolytic/Betrixaban
- Anticoagulants, Antiplatelets/Tipranavir
Moderate Interactions include:
- Apixaban/Aspirin (<OR=100mg)
- Apixaban/P-GP with moderate CYP3A4 inhibitors
- Apixaban, Dabigatran, Fluconazole/Rivaroxaban
- Antiplatelets, Anticoagulants, Thrombolytic/SNRI’S,SSRI’S,
Always check all your nonprescription and prescription medicines labels for any ingredients that can affect apixaban. Most of these contain fever reducers and pain relievers such as NSAIDs (naproxen, ibuprofen) and aspirin, which may increase the risk of bleeding when taken together with ELIQUIS.
However, your doctor can prescribe you aspirin in low doses (usually 81-325 milligrams daily) to prevent stroke or heart attack. If so, you should follow your doctor’s instructions until he or she instructs you otherwise. You may talk to your pharmacist or doctor to get more information if you have questions or concerns.
Foods to Avoid when Taking ELIQUIS
a change in diet may be necessary when you start taking ELIQUIS. Your doctor will advise you on any necessary changes that may affect you given your medical history and taking into consideration any other medications that you may be taking as at the date of your prescription.
t here have been some recorded interactions in people who take apixaban and grapefruits together. This is because apixaban is processed by enzymes present in your intestine while grapefruit juice and grapefruits contain compounds that can slow down the process.
If this interaction occurs, the amount of apixaban present in your blood may increase causing a higher probability of side effects than expected. This may include bleeding, nosebleeds, bleeding from your gums, passing dark stool, and unusual bruising.
It is prudent that you avoiding drinking grapefruit juice or eating grapefruits while you are taking ELIQUIS. Instead, you may settle for another citrus beverage such as lemonade or orange juice. If your doctor or any other healthcare professional advice you to eat grapefruits or drink grapefruit juice, you should immediately consult them on the effects of the fruit on blood levels of ELIQUIS.
If you notice any of the above interactions such as unusual bleeding or passing of dark stool, contact your doctor immediately. Since the healthcare professional in charge of your care may be monitoring the level of this interaction on your behalf, you should check with them first before making a decision to start, stop, or change your dosage.
y our doctor will write you a prescription for ELIQUIS as well as its dosage and administration. However, the recommended dosage of the drug for most patients is 5mg twice a day taken orally. On the other hand, the recommended dosage of 2.5mg twice a day is for patients exhibiting at least two of the three characteristics below:
- Those aged 80 and above
- Those who weigh 60kg and below
- Those with a serum creatinine level of 1.5mg/dL or greater
If you experience prophylaxis of deep vein thrombosis after a hip or knee replacement surgery, your recommended ELIQUIS dosage is 2.5mg taken twice per day. The first dose should be taken between 12 and 24 hours after surgery. If you are undergoing hip replacement surgery, you recommended treatment duration is 35 days. If you are undergoing knee replacement surgery, your treatment duration is 12 days.
When ELIQUIS is used in the treatment of PE and DVT, your recommended dose is 10mg taken twice a day for the first seven therapy days. After a week, your dosage is reduced to 5mg. After at least six months of treatment for PE and DVT,the recommended ELIQUIS dosage is 2.5mg taken twice a day to reduce the risk of recurrence.
i f you notice or suspect overdose symptoms such as troubled breathing or passing out call 911 immediately. You may also call your local poison control center for assistance. If you are a US resident, you can reach your local center at 1-800-222-1222. Other overdose symptoms may include tarry or bloody stool, dark/pink urine, and unusual/prolonged bleeding.
You should never share your ELIQUIS medication with anybody else. It is recommended to perform periodic laboratory and medical tests such as red blood cell count or hematocrit/hemoglobin to check for side effects and monitor your progress. You should consult your physician if you are concerned that they are not monitoring you regularly.
If you miss a dose of ELIQUIS, take it when you remember. However, if you remember to take your dose near the time for the next one, skip the missed one and resume your dosing schedule. Whatever you do, do not take double your dosage to catch up as it may have negative side effects.
Storage of ELIQUIS
s tore your ELIQUIS medicine at room temperature away from moisture and light. Refrain from storing the medicine in your bathroom. Improper storage may cause the medicine to go bad, which can have unexpected side effects when you take it. Keep all medications away from your pets and children. If you decide to crush the tablet and mix it in water, applesauce, or apple juice (as directed by your physician) take the mixture within four hours of its preparation.
Do not make a habit of flushing unused medications down your toilet or pouring it into a drain unless it is okay to do so. Always discard ELIQUIS and any other medications properly when it is no longer needed or expired. If you do not know how to discard medicine properly, you may contact your pharmacist or your local waste disposal company for advice.
i n the United States, defective products including medical devices and dangerous pharmaceutical drugs cause thousands of injuries on an annual basis. Thus, there exist product liability laws that protect consumers and ensure that they are compensated for any damages caused by defective products in the market.
Product liability laws follow the principle that companies and manufacturers have a duty to protect the consumers of their products from potential hazards. In the past, courts have held that producers and manufacturers have more insight of their products, which makes it their responsibility and duty to assume financial responsibility for the damages and injuries caused.
All states have varied product liability laws with different sets of rules and procedures that are different from personal injury laws. These laws offer victims of defective products with legal recourse if an injury occurs. Manufacturers of products such as ELIQUIS are required to make products that meet your ordinary expectations as a consumer. When their product has an unexpected defect, then it cannot be said to have met those expectations. As a result, and depending on the defect type, different parties may be liable for the injuries that result from the use of the defective product.
Pharmaceutical Drug Liability
o ften, drugs, medicines, and medical devices are at the center of product liability lawsuits. Manufacturers are required by pharmaceutical law to conduct all appropriate tests before releasing medicines, drugs, and medical devices into the market. Furthermore, they must follow the U.S. Food and Drug Administration’s (FDA) testing criteria that are regarded as the industry’s standards.
The fact that a product was licensed by the FDA and followed all issued protocols before it was released to the market does not exempt it from liability if it is found to be defective and proven to cause injury to you as the consumer.
Most medical products, except over-the-counter drugs, characteristically have a learned intermediary who comes between the manufacturer and consumer. This intermediary could be your doctor, a nurse, or a pharmacist who, respectively, prescribes the drug, instructs you on its proper use, and fills your prescription. Over the counter drugs can be bought without a prescription and, thus, may not have an intermediary.
The presence of an intermediary can blur the lines of liability since it may be difficult to prove who is at fault for an injury if you ELIQUIS medication causes you injury such as permanent paralysis. Such cases are the reason why it is prudent to hire an experienced attorney or law firm to help you determine who is liable for your injury or if you have a strong case to file in court.
Unavoidably unsafe products refer to some prescription medications that, no matter how careful their manufacture is, cannot be made completely safe. Although unavoidably unsafe drugs may have potentially harmful side effects, they can still be prescribed to you if their benefits outweigh the risks. However, if these products are well prepared, prescribed, and accompanied by properly labeled warnings, they usually do not result in a successful products liability suit.
A drug manufacturer has a duty to warn all consumers of any known side effects of their drugs, but are not expected to give warnings of unknown dangers. Despite this, manufacturers discharge this duty by making all the relevant information concerning their drugs available to a patient’s physician or pharmacist. Since a drug manufacturer is considered an expert in their chosen field, they have a continuing duty to always remain informed in all things concerning their products and take reasonable steps to keep medical professionals abreast of any necessary information such as newly-reported adverse effects.
Finding Help for an ELIQUIS (Apixaban) Lawsuit Near Me
p roduct Liability actions involving pharmaceutical drugs like ELIQUIS (Apixaban) are usually quite complex especially when it comes to establishing legal fault and managing the lawsuit from start to finish. Such cases require the assistance of expert witnesses and investigators during the discovery period and throughout the duration of the case. Contact Consumer Alert Now at (800) 511-0747 if you need to hire seasoned attorneys to look at your ELIQUIS lawsuit. We operate nationwide.