To prevent blood clots after hip or knee replacement surgery
This booklet contains information for those who have been prescribed
ELIQUIS® (apixaban) after hip or knee replacement surgery
Always read the package leaflet in the medicine pack
You have received this booklet because your doctor has prescribed ELIQUIS® for you in order to prevent blood clots after hip or knee replacement surgery.
ELIQUIS® will play an important role in your recovery by preventing the formation of blood clots. This booklet explains how it works and gives you some tools as a help during this period. You should also read the package leaflet in the medicine pack.
What is venous thromboembolism (VTE)?
The word “venous” tells us that something is related to the veins (a type of blood vessel). A thrombus occurs when a blood vessel, which transports blood around in the body, is blocked by a blood clot (a thrombus). If a blood clot comes loose from the place where it was formed and follows the blood until it gets stuck in a narrower blood vessel elsewhere in the body, it is called an embolism.
A deep vein thrombosis (DVT) is a blood clot formed in the deep veins of the legs that pass through the muscles of the calves and thighs.
A DVT can block the blood flow of the vein wholly or partially, and cause symptoms such as pain, tenderness and swelling of the calf, which may sometimes become warm and red. In some cases, no symptoms are observed and the DVT is first diagnosed if a complication occurs, such as a pulmonary embolism (clot in the lung).
In a pulmonary embolism (PE), part of a blood clot breaks loose from a DVT and is transported to the narrower vessels in the lungs and gets stuck there. This causes it to block blood flow to a part of the lung. The symptoms of a PE are chest pain and shortness of breath and require immediate treatment. If you should experience such symptoms, you must contact a doctor or healthcare provider immediately.
Venous thromboembolism (VTE) is a term that includes both DVT and PE.
What is the cause of VTE?
Blood coagulation is a natural process that stops bleeding. Movement of the leg muscles helps to push back the blood through the deep leg veins to the heart, so that a normal blood flow is maintained.
If the blood flow through the veins is slower than usual, the blood may begin to coagulate and form blood clots. This happens more often during periods of reduced mobility, such as during and after surgery. The risk of such blood clots also increases after a major operation, as the blood becomes thicker when the body tries to stop the blood loss and heal the blood vessels injured during surgery.
Although not all patients who have undergone surgery develop a blood clot, some types of VTE may be serious. It is really important to try to prevent these blood clots from forming at all.
How can we prevent VTE?
We can reduce the risk of VTE as follows:
The stockings prevent blood from accumulating in the deep veins. In this way, they help to maintain a normal blood flow.
Leg and foot movements:
Your physiotherapist will give you an exercise programme that you must follow after the operation. By exercising the foot and leg muscles, you help maintain a normal blood flow in the deep veins.
Plenty of fluids:
By ensuring that your body has enough water, you can reduce the risk of blood clots.
Intermittent pneumatic compression (IPC):
This method is only used by some patients while they are in the hospital. If the patient’s mobility is severely impaired, these “boots” can be used to squeeze the leg muscles
(by alternately inflating and deflating the boots), thus maintaining a normal blood flow.
Blood thinners (anticoagulants):
These medicines thin the blood so that there is less risk of blood clots. Some agents are given as injections, while others are taken as tablets or capsules.
Your doctor may have chosen one or more of these preventive measures to reduce the risk of VTE
Why has your doctor prescribed you ELIQUIS®?
ELIQUIS® is used in adult patients to prevent blood clots from forming after hip or knee replacement surgery.
ELIQUIS® contains the active substance apixaban and belongs to a group of medicines called anticoagulants (blood thinners).
ELIQUIS® helps prevent blood clots from forming by blocking one of the substances that causes the blood to coagulate (factor Xa).
How should ELIQUIS® be taken?
You should always take ELIQUIS® exactly as instructed by your doctor. Consult your doctor or pharmacist if you are not sure.
The usual dose of ELIQUIS® is a 2.5 mg tablet twice a day, for example, one in the morning and one in the evening. Try to take the tablets at the same time every day.
You should swallow the ELIQUIS® tablet with a glass of water. You can take it with or without food.
How long does treatment with ELIQUIS® last?
The length of treatment depends on the type of surgery you have undergone. Always follow the doctor’s instructions.
Frequently asked questions:
What should I do if I forget a dose?
If you forget to take a dose of ELIQUIS® you should take the tablet as soon as you remember, then take the next ELIQUIS® tablet at the usual time, and then continue as usual. If you are unsure, ask your doctor or pharmacist.
What should I do if I have taken too much ELIQUIS®?
Talk to your doctor immediately if you have taken more than the prescribed dose of ELIQUIS®. Bring the medicine pack to the doctor, even if there are no tablets left. If you take more ELIQUIS® than recommended, you are at increased risk of bleeding.
Things to keep in mind when taking ELIQUIS®
Be sure to tell your doctor if you are taking any other medicines, including over-the-counter medicines and herbal medicines (e.g. St. John’s Wort). Some medicines and supplements may interfere with the anti-coagulation effect of ELIQUIS® and either increase the risk of bleeding or cause the drug to be less effective. You will find a complete list of medicines that may affect ELIQUIS® in the package leaflet in the medicine pack.
You should not take ELIQUIS® if you are pregnant, breastfeeding or have a liver disease or bleeding disorder. Therefore, please tell your doctor if any of these apply to you.
Possible side effects
Like all medicines, ELIQUIS® can cause side effects, although not all users experience them.
Like other similar medicines (blood thinners), ELIQUIS® may cause life threatening bleeding. The bleeding may not be noticeable, but it can still lead to anaemia (a condition with low blood counts that can cause fatigue or pale skin).
Other common side effects are bruising, blood in the urine (which stains it pink or red) and nausea.
For a full list of possible side effects, see the package leaflet in the ELIQUIS® pack.
Tell your doctor or pharmacist if you experience any side effects, even if they are not included in the package leaflet or in this booklet.
Good luck with your rehabilitation!
ELIQUIS®: Prescribing Information
Eliquis® belongs to a group of medicines called anticoagulants (blood thinners). This medication helps prevent blood clots from forming by blocking factor Xa, which is an important component in the clotting of blood. The active substance in Eliquis® is called apixaban. Eliquis® is available as film-coated tablets in strengths of 2.5 mg and 5 mg. Eliquis® is used for adults: 1. To prevent blood clots (deep vein thrombosis, DVT) from forming after hip or knee joint surgery. 2. To prevent blood clots from forming in the heart of patients with an irregular heart rhythm (atrial fibrillation) and at least one more risk factor. Blood clots can come loose and be transported to the brain and cause a stroke, or to other organs and prevent normal blood flow to these organs. 3. To treat blood clots in the leg veins (deep vein thrombosis) and in the blood vessels of the lungs (pulmonary embolism) and to prevent blood clots from recurring in the blood vessels in the legs and/or the lungs. Do not use Eliquis® if: you are allergic to apixaban or any of the other ingredients in this medicine, you bleed a lot, you have a disease in a body organ that increases the risk of severe bleeding (such as current or recent ulcers in the stomach or intestine, recent bleeding in the brain), you have a liver disease that leads to increased risk of bleeding (hepatic coagulopathy), you are taking medicines to prevent blood clots (e.g. warfarin, rivaroxaban, dabigatran or heparin), except when changing anticoagulation treatment or while you have a venous or arterial catheter and you are receiving heparin to keep it open, you have an artificial heart valve.
For full information about Eliquis®, carefully read the package leaflet that accompanies the pack (see also www.fass.se). This text is based on the package leaflet from October 2017.
Bristol-Myers Squibb AB, Tel. 08 704 71 00, www.bms.com/se.
Pfizer, Tel. 08-550 52 000, www.pfizer.se.
432SE18NP01848-01 PP-ELI-SWE-0806APR 2018