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INDICATIONS

Understanding the Risks

After Hip or Knee Replacement Surgery, You May Be at an Increased Risk for
Blood Clots

If you have had hip or knee replacement surgery, you should know about the risk of developing blood clots in the legs and lungs.

Why might you be at an increased risk?

  • The surgery itself: Replacing a joint activates your body’s blood-clotting response
  • The postsurgery recovery: After surgery, you’re less active for several days or weeks. That can cause blood flow to slow down, which increases the risk of developing blood clots

A common type of blood clot that people may have after hip or knee replacement surgery is called deep vein thrombosis, or DVT.


SEE ALSO:
How ELIQUIS May Help


DVT is a blood clot in a vein (usually in the thighs or pelvis) that may block the flow of blood. DVT can cause many symptoms, including pain, swelling, and redness of the skin. But it’s also possible that patients with DVT may experience no symptoms at all.

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From Legs to Lungs:
DVT May Lead to
a Pulmonary Embolism

Sometimes a DVT blood clot can break free and travel to the lungs. This can lead to a serious condition known as pulmonary embolism (PE). PE can limit the blood flow to the lungs and carries the risk of sudden death.

Watch this animation for a better understanding of how a DVT blood clot can turn into a PE clot:

 
 
 
 
HOW A CLOT IN THE LEGS (DVT) CAN TURN INTO A CLOT IN THE LUNGS (PE)
 

The symptoms of PE may include:

  • Difficulty breathing
  • Faster than normal or
    irregular heartbeat
  • Chest pain
  • Coughing up blood
  • Very low blood pressure,
    light-headedness, or fainting

Just like with DVT, some patients with PE may also have no symptoms.

What can help reduce the risk of having DVT/PE?
There are medicines that can help reduce the risk of forming a DVT/PE blood clot after a hip or knee replacement surgery. Your doctor may prescribe a medicine called an anticoagulant, a type of blood thinner, that may help lower your chance of developing a blood clot.

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Important facts about
ELIQUIS® (apixaban) & INDICATIONS

This is a summary of important information that you need to know about ELIQUIS. Keep this document in a safe place, so you can refer to it before and during your treatment.

  • Look out for the following icons as you read:
  • Talk to your healthcare team
  • Call a healthcare provider right away
  • Helpful information to remember

Do not stop taking ELIQUIS without talking to the doctor who prescribed it to you
For patients taking ELIQUIS for atrial fibrillation: stopping ELIQUIS increases your risk of having a stroke.

Talk to your healthcare team before any medical procedures. ELIQUIS may need to be stopped before surgery, or a medical or dental procedure. Your doctor will tell you when you should stop taking ELIQUIS and when you may start taking it again. If you have to stop taking ELIQUIS your doctor may prescribe another medicine to help prevent a blood clot from forming.


What are the possible serious side effects of ELIQUIS?
This is a list of some of the serious side effects of ELIQUIS.

Bleeding

ELIQUIS can cause bleeding, which can be serious, and rarely may lead to death. This is because ELIQUIS is a blood thinner medicine that reduces blood clotting. While taking ELIQUIS, you may bruise more easily and it may take longer than usual for any bleeding to stop.

You may have a higher risk of bleeding if you take ELIQUIS with other medicines that increase your risk of bleeding, such as:

  • Aspirin
  • Nonsteroidal anti-inflammatory drugs (called NSAIDs)
  • Warfarin (COUMADIN®)
  • Heparin
  • Selective serotonin reuptake
    inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)
  • Other medicines to help prevent or treat blood clots

Tell your doctor if you take any of these medicines.

Call your doctor or get medical help right away if you have any of these signs or symptoms of bleeding when taking ELIQUIS:

  • Unexpected bleeding or bleeding that lasts a long time, such as:
    • Unusual bleeding from the gums
    • Nosebleeds that
      happen often
    • Menstrual or vaginal
      bleeding that is heavier than normal
  • Bleeding that is severe or you cannot control
  • Red, pink, or brown urine
  • Red or black stools (looks like tar)
  • Coughing up or vomiting blood
  • Vomit that looks like coffee grounds
  • Unexpected pain, swelling, or joint pain
  • Headaches
  • Feeling dizzy or weak

Spinal or epidural blood clots (hematoma)

People who take ELIQUIS, and have medicine injected into their spinal or epidural area, or have a spinal puncture, have a risk of forming a blood clot that can cause long-term or permanent loss of the ability to move (paralysis).

Your risk of developing a spinal or epidural blood clot is higher if:

  • A thin tube called an epidural catheter is placed in your back to give you certain medicine
  • You take NSAIDs or a medicine to prevent
    blood
    from clotting
  • You have a history of difficult or repeated epidural or
    spinal punctures
  • You have a history of problems with your spine, or have had surgery on your spine

If you take ELIQUIS and receive spinal anesthesia or a spinal puncture, your doctor should watch you closely for symptoms of spinal or epidural blood clots
or bleeding.

Tell your doctor right away if you have any of these signs or symptoms (especially in your legs and feet) when taking ELIQUIS:

  • Tingling
  • Numbness
  • Muscle weakness

A reaction to ELIQUIS itself

A reaction to ELIQUIS can cause hives, rash, itching, and possibly trouble breathing. If you get this reaction, it will usually happen soon after you take a dose of ELIQUIS.

Get medical help right away if you have any of the following symptoms:

  • Sudden chest pain or chest tightness
  • Sudden swelling of your face or tongue
  • Trouble breathing
  • Wheezing
  • Feeling dizzy or faint

Talk to your doctor about any side effect that may be bothering you or that does not go away. These are not all of the possible side effects of ELIQUIS. Call your doctor for medical advice about side effects.

You are encouraged to report any side effects to the FDA at 1-800-FDA-1088.


Who should not take ELIQUIS?

ELIQUIS is not for patients who:

  • have artificial heart valves.
  • currently have certain types of abnormal bleeding.
  • have had a serious
    allergic
    reaction to ELIQUIS.

What should I discuss with my healthcare team before starting ELIQUIS?

Talk to your healthcare team about the following:

  • Kidney or liver problems
  • Any other medical conditions
  • If you have ever had bleeding problems

Tell your doctor if you are pregnant or breastfeeding, or planning to become pregnant or breastfeed. You and your doctor should decide if you will take ELIQUIS or breastfeed. You should not do both.

Tell your healthcare team about all of the medications you are taking, including:

  • Prescriptions
  • Over-the-counter medicines
  • Herbal supplements
  • Vitamins

During treatment, make sure you talk to your healthcare team before you begin to take any new medication.


How should I take ELIQUIS?

Take ELIQUIS exactly as prescribed by your doctor.

Twice daily
With or without food

Do not change your dose or stop taking ELIQUIS unless your doctor tells you to.

What if I miss a dose of ELIQUIS?

If you miss a dose of ELIQUIS, take it as soon as you remember, and do not take more than one dose at the same time.

When should I refill my prescription?

If you are taking ELIQUIS for atrial fibrillation, stopping ELIQUIS may increase your risk of having a stroke. Do not run out of ELIQUIS. Refill your prescription before you run out. When leaving the hospital following hip or knee replacement, be sure that you will have ELIQUIS available to avoid missing any doses.

ELIQUIS is available in two different tablets. Your doctor or healthcare provider will determine what dose is right for you.

2.5 mg tablet

Round, with a pale yellow color

OR

5 mg tablet

Oval, with a pale orange or pink color

Note: Images do not represent actual tablet size.

On one side of each tablet, there is a number indicating the dosage strength of the tablet (in milligrams). On the other side, there is a medication identification number.


What is ELIQUIS?
ELIQUIS is a prescription medicine used to:

Reduce the risk of stroke and blood clots in people who have atrial fibrillation (AFib),
a type of irregular heartbeat, not

caused by a heart valve problem.

Treat blood clots in the veins of the legs (deep vein thrombosis – DVT) or lungs
(pulmonary embolism – PE), and reduce

the risk of them occurring again.

Reduce the risk of forming a blood clot in the legs (DVT) and lungs (PE) of people
who have just had hip or knee replacement surgery.

Please see U.S. Full Prescribing Information, including Boxed WARNINGS and Medication Guide.

LOVENOX® is a registered trademark of Aventis Pharma S.A.

This independent, non-profit organization provides assistance to qualifying patients with financial hardship who generally have no prescription insurance. Contact 1-800-736-0003 or visit www.bmspaf.org for more information.

The product information provided in this site is intended only for residents of the United States. The products discussed herein may have different product labeling in different countries.

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

432US1703386-01-01  12/17

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SELECTED IMPORTANT SAFETY INFORMATION

For people taking ELIQUIS® (apixaban) for atrial fibrillation: Do not stop taking ELIQUIS without talking to the doctor who prescribed it for you. Stopping ELIQUIS increases your risk of having a stroke.

ELIQUIS may need to be stopped prior to surgery or a medical or dental procedure. Your doctor will tell you when you should stop taking ELIQUIS and when you may start taking it again. If you have to stop taking ELIQUIS, your doctor may prescribe another medicine to help prevent a blood clot from forming.

ELIQUIS can cause bleeding, which can be serious, and rarely may lead to death. This is because ELIQUIS is a blood thinner medicine that reduces blood clotting.

You may have a higher risk of bleeding if you take ELIQUIS and take other medicines that increase your risk of bleeding, such as aspirin, nonsteroidal anti-inflammatory drugs (called NSAIDs), warfarin (COUMADIN®), heparin, selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs), and other medicines to help prevent or treat blood clots. Tell your doctor about all of the medicines you take, including any over-the-counter medicines, vitamins, and herbal supplements.