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It is important not to discontinue the use of apixaban without your doctor's guidance. Stopping this medication prematurely may significantly increase your risk of developing serious blood clots, including strokes or clots in the legs or lungs. Your doctor might recommend switching to another anticoagulant or antiplatelet medication to help mitigate this risk.

Be alert for symptoms that require immediate medical attention, such as:

• Weakness on one side of the body
• Difficulty speaking
• Sudden changes in vision
• Confusion
• Chest pain
• Breathing difficulties
• Pain, warmth, or swelling in the legs

Individuals taking apixaban may experience bleeding around the spinal cord following certain spinal procedures, potentially leading to long-lasting or permanent paralysis. Before undergoing any spinal procedure, discuss the potential benefits and risks with your doctor. The likelihood of bleeding increases if you have a spinal deformity, have previously undergone spinal procedures or surgeries (such as epidural catheter placement or complex epidural/spinal puncture), or are using other medications that may cause bleeding or bruising. These medications include antiplatelet drugs like clopidogrel, anticoagulants such as warfarin or enoxaparin, and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

Report the following symptoms to your healthcare provider immediately:

• Back pain
• Numbness, tingling, or weakness in the legs
• Loss of bowel or bladder control (incontinence)

You might experience mild side effects such as nausea, easy bruising, or minor bleeding like nosebleeds or bleeding from cuts. These are generally not serious and often do not require medical attention. However, if these symptoms persist or worsen, consider discussing them with your healthcare provider for reassurance and guidance.

More severe side effects can occur if the medication impacts your blood clotting proteins significantly. Be alert for signs of serious bleeding, such as frequent or persistent nosebleeds, unusual tiredness, pain, swelling, or discomfort, as well as unusual bruising. Watch for prolonged bleeding from cuts or gums, heavy or extended menstrual flow, pink or dark urine, coughing up blood, vomit resembling coffee grounds, severe headaches, dizziness, fainting, bloody or black stools, and difficulty swallowing. These symptoms require immediate medical attention.

In very rare cases, a serious allergic reaction may occur. Seek urgent medical help if you experience symptoms such as a rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, or trouble breathing.

This is not a comprehensive list of side effects, so if you notice any other unusual symptoms, reach out to your healthcare provider for advice.

Some medicines may interact with this drug, leading to potential health risks. These include Mifepristone, medications that can lead to bleeding or bruising, such as antiplatelet drugs like Clopidogrel, nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Naproxen, and blood thinners like Warfarin and Enoxaparin. Additionally, certain antidepressants, including SSRIs like Fluoxetine and SNRIs like desvenlafaxine and Venlafaxine, can also interact.

Moreover, some medications can alter how apixaban is processed in your body, affecting its effectiveness. These include certain antifungal medications, such as Itraconazole, Ketoconazole, and Posaconazole, the drug conivaptan, HIV protease inhibitors such as lopinavir, antibiotics like Rifabutin, Ritonavir, St. John's wort, and some seizure medications like Carbamazepine and Phenytoin.

Aspirin can heighten the risk of bleeding when combined with this medication. Nonetheless, if your healthcare provider has advised you to take low-dose aspirin to reduce the risk of a heart attack or stroke (typically 81-162 milligrams daily), continue taking it unless directed otherwise by your doctor. For more information, consult your doctor or pharmacist.