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Apixaban

  • Prescription medicine
  • Prescription only
  • Identity checked
  • Sources last checked 2026-09-04

This page shows what was measured, who it was measured in, and what that does not settle.

What Apixaban does in the body

Apixaban blocks one enzyme near the point where the chain converges and multiplies, so far less thrombin is produced and clots form much more slowly.

Clotting is a chain reaction where each step makes much more of the next. Unlike warfarin it acts directly on the enzyme rather than on how the liver builds it, so it works within hours and needs no blood test to guide the dose.

Why people take it. Used to prevent stroke and to treat or prevent blood clots.

What happened in people

Compared with warfarin, apixaban caused fewer strokes, less major bleeding and fewer deaths.

Reviewed first-read answer

Where this came from

A person wrote this and a reviewer approved it against this exact record. It carries no effect size.

A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.

No source is stored against this line.

The limit that matters most

Most of the stroke difference came from fewer brain bleeds, not fewer clot-caused strokes.

Where it acts
Circulating plasma and the prothrombinase complex on activated platelet membranes
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.

What the registries record it as

  • Its recorded molecular formula is C25H25N5O4, weighing 459.5.

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

Where each sentence above came from

A person wrote this explanation into the record, with the studies named in the path below.

A reviewer approved this sentence against this exact record and its sources.

The limit a reviewer approved as the one that matters most here.

The four opening statements run to 93 words.

Words this page uses

Four words worth knowing first

Chosen from what this page shows, with each one explained before the word it depends on.

Stand-in result

A stand-in result is a number measured because the real result takes too long.

A picture of it, and where the picture fails

It is like judging a journey by the speedometer rather than by arriving.

Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.

What people get wrong. A stand-in result is often reported as the result itself.

A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.

Randomisation

Randomisation means chance decides who gets which treatment.

A picture of it, and where the picture fails

It is like a coin toss deciding the groups.

Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.

What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.

Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.

Absolute difference

An absolute difference is how many more people in a hundred were affected.

A picture of it, and where the picture fails

It is like counting heads in two rooms of a hundred.

Where that stops being true. Heads are easy to count. Study results carry a margin of error too.

What people get wrong. It is confused with a percentage change, which can look far larger.

The arithmetic difference in event rates between arms.

Confidence interval

A confidence interval is the range the true answer is likely to sit in.

A picture of it, and where the picture fails

It is like a weather forecast giving a range rather than one number.

Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.

What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.

An interval estimate that would contain the true parameter in a stated proportion of repeated studies.

What happened in peopleRead from sources, not yet reviewed

What was measured, goal by goal

One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.

Registered studies list 40 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.

There is no single score. A strong test result and a weak life result are different facts.

Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
GoalLife outcomeWhat a body can doHow a person feelsA test resultA step in the bodyHarmsHow longWho was studied
PainNothing in the sources checkedNo registered study lists a life outcome for this goal.Nothing in the sources checkedNo registered study lists a performance measure for this goal.Waiting for a reviewer1 registered symptom measure.Nothing in the sources checkedNo registered study lists a test result for this goal.Nothing in the sources checkedNo registered study lists a body-step measure for this goal.Not recordedHarms were not a registered measure for this goal.Not recordedNo finished study window is recorded.Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Pain
pain as measured by visual analog scale

Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.

What each mark on this table means
Nothing in the sources checked
No registered study lists a life outcome for this goal.
Waiting for a reviewer
1 registered symptom measure.
Not recorded
Harms were not a registered measure for this goal.

What happened in peopleRead from sources, not yet reviewed

What happened in people

Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.

Ischaemic or haemorrhagic stroke or systemic embolism

The study showed what it set out to show

Who was studied
ARISTOTLE (NCT00412984)
How many people
18201
Study design
Randomised double-blind active-controlled trial, median 1.8 years
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
HR 0.79 (95% CI 0.66-0.95), P < 0.001 for non-inferiority and P = 0.01 for superiority
Repeated elsewhere
Replicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. Ischaemic or uncertain-type stroke was not significantly reduced (HR 0.92, p=0.42). The composite advantage came from haemorrhagic stroke.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, twice daily, in two strengths

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Stroke or systemic embolism, apixaban versus aspirin, in patients unsuitable for a vitamin K antagonist

The study showed what it set out to show

Who was studied
AVERROES (NCT00496769)
How many people
5599
Study design
Randomised double-blind active-controlled trial, stopped early, mean 1.1 years
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
HR 0.45 (95% CI 0.32-0.62), P < 0.001
Repeated elsewhere
Unreplicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. Death from any cause was 3.5% against 4.4% per year but did not reach significance (p=0.07). Early stopping inflates measured effect size.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, twice daily, in two strengths

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Recurrent symptomatic venous thromboembolism or venous-thromboembolism-related death

The study showed what it set out to show

Who was studied
AMPLIFY (NCT00643201)
How many people
5395
Study design
Randomised double-blind active-controlled trial, 6 months
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
RR 0.84 (95% CI 0.60-1.18); non-inferiority met at P < 0.001. Major bleeding RR 0.31 (0.17-0.55), P < 0.001 for superiority.
Repeated elsewhere
Replicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. No limitation is recorded for this study.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, twice daily, in two strengths

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Cardiovascular death, myocardial infarction or ischaemic stroke added to antiplatelet therapy after acute coronary syndrome

The study did not show it

Who was studied
APPRAISE-2 (NCT00831441)
How many people
7392
Study design
Randomised double-blind placebo-controlled trial, terminated early, median 241 days
Compared against
A dummy treatment
Kind of result
Living longer, or avoiding a major event
What was found
HR 0.95 (95% CI 0.80-1.11), P = 0.51
Repeated elsewhere
Failed to Replicate

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. TIMI major bleeding HR 2.59 (1.50-4.46), p=0.001, with more intracranial and fatal bleeding. The trial was stopped for harm without benefit.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, twice daily, in two strengths

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Thirty-day composite of venous-thromboembolism-related death, pulmonary embolism, symptomatic deep-vein thrombosis or asymptomatic proximal-leg thrombosis

The study did not show it

Who was studied
ADOPT (NCT00457002)
How many people
6528
Study design
Randomised double-blind double-dummy active-controlled trial, 30 days
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
RR 0.87 (95% CI 0.62-1.23), P = 0.44
Repeated elsewhere
Failed to Replicate

What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.

The limits of this study, and where it came from

Main limit. Major bleeding 0.47% against 0.19%, RR 2.58 (1.02-7.24), p=0.04. No efficacy gain and more bleeding.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, twice daily, in two strengths

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

Stroke or systemic embolism in device-detected subclinical atrial fibrillation of 6 minutes to 24 hours

The study showed what it set out to show

Who was studied
ARTESIA (NCT01938248)
How many people
4012
Study design
Randomised double-blind double-dummy active-controlled trial, mean 3.5 years
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
HR 0.63 (95% CI 0.45-0.88), P = 0.007
Repeated elsewhere
Unreplicated

What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.

The limits of this study, and where it came from

Main limit. Major bleeding 1.71% against 0.94% per patient-year, HR 1.80 (1.26-2.57), p=0.001 — an absolute bleeding increase larger than the absolute stroke reduction.

How far it carries. This study is recorded from the curated record, not from the registry match.

Form and route. Oral tablet, twice daily, in two strengths

Interval reported. 95% CI 0

Written into the record, not signed off as a reviewed claim.

What we know
RNAWiki holds 6 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.

What happened in peopleRead from sources, not yet reviewed

How close this is to real life

The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.

  1. Living longer, or avoiding a major event Evidence recorded. Death, a heart attack, a stroke, a hospital stay.8 registered measures of this kind. 2 written-up studies measured this and did not show a benefit.
  2. What a body can do day to day No evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
  3. Measured performance No evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
  4. Symptoms and quality of life Evidence recorded. Pain, tiredness, mood, sleep, as the person rated it.1 registered measure of this kind.
  5. A number that stands in for health Evidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.1 registered measure of this kind.
  6. A step measured inside a person Evidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
  7. Animals No evidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.No animal record is stored.
  8. Cells in a dish No evidence recorded. Cells or chemistry on a bench, far from a whole body.No cell or bench record is stored.
  9. A guess from software No evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.

Higher on these steps means closer to something a person would feel. It does not mean better done.

What it changes in the bodyRead from sources, not yet reviewed

The path through the body

From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.

Where a source records it acting

  • Blood and vessels: Factor Xa inhibitor; reduces the risk of stroke and systemic embolism in nonvalvular atrial fibrillation

    US prescribing information · 095a08ac-cf0e-497e-a682-ddef38d6b29c · read 2026-08-27

  1. Start

    Apixaban

    What a person takes: Oral tablet, twice daily, in two strengths.

    The measurement behind this step

    Twice daily with or without food. No routine coagulation monitoring is used, which removes the burden of the INR clinic and also removes the mechanism that would detect a patient who has stopped taking it. Absorption is dissolution-limited at higher strengths, which is why particle size is a manufacturing specification.

  2. Getting in

    Absorbed within hours and cleared by several routes at once

    The tablet works within a few hours. The body removes it by a mixture of liver metabolism, gut excretion and kidney clearance, so no single route dominates.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Oral bioavailability is about 50%, with peak concentration at 3 to 4 hours and a half-life around 12 hours. Elimination is multi-route: roughly 27% renal, with CYP3A4-mediated metabolism, biliary and direct intestinal excretion accounting for the remainder. Because no single pathway carries the whole load, renal impairment affects apixaban less than the other factor Xa inhibitors.

  3. Reaching the cell

    It works in the plasma, not inside any cell

    Its target floats in the blood and assembles on the surface of activated platelets. Nothing has to be transported into a cell.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    Factor Xa circulates free and assembles with factor Va, calcium and anionic phospholipid on activated platelet membranes to form the prothrombinase complex. Apixaban inhibits both free and complex-bound factor Xa, and factor Xa within a formed clot — the pharmacological gap that heparins, which act indirectly through antithrombin, cannot reach.

  4. What it acts on

    A rigid bicycle spans two pockets of the enzyme at once

    The molecule is stiff and holds two arms exactly the right distance apart to fill two neighbouring grooves in the enzyme, which is why it binds so tightly.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    The fused pyrazolo-pyridinone core is planar and conformationally locked, positioning the 4-methoxyphenyl group in the S1 pocket and the phenyl-valerolactam in the S4 aryl-binding box. Unusually for a factor Xa inhibitor, the S1 group is neutral rather than a basic amidine, which is what gives the molecule oral bioavailability where the earlier amidine-containing inhibitors had none.

  5. The change it makes

    Thrombin generation collapses at the amplification step

    Because each blocked enzyme would have produced about a thousand molecules of the next one, blocking it here has an outsized effect on how much clotting protein gets made.

    Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.

    The measurement behind this step

    One molecule of factor Xa in the prothrombinase complex generates on the order of a thousand thrombin molecules, so inhibition at this node throttles the cascade before amplification. Thrombin generation falls, and with it fibrin formation, thrombin-mediated platelet activation and factor XIII-mediated clot stabilisation. Platelet function itself is untouched, which is why apixaban and antiplatelet drugs have additive bleeding risk — the mechanism behind APPRAISE-2.

  6. What that does for a person

    Fewer strokes and fewer brain bleeds than warfarin, and more bleeding than aspirin

    Against warfarin the drug wins on strokes, bleeding and deaths at once. Against aspirin it prevents far more strokes at the cost of more bleeding. Added on top of antiplatelet drugs, it bleeds without helping.

    Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.

    The measurement behind this step

    In ARISTOTLE, stroke or systemic embolism 1.27% against 1.60% per year, major bleeding 2.13% against 3.09%, death 3.52% against 3.94%. In ARTESIA, stroke 0.78% against 1.24% per patient-year with major bleeding 1.71% against 0.94%. In APPRAISE-2, ischaemic hazard ratio 0.95 with TIMI major bleeding hazard ratio 2.59.

No suggested links are held for this record, so nothing is hidden from this path.

What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.

What it would be like to takeRead from sources, not yet reviewed

Felt, measured, or meaningful

Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.

Felt

Things a person could notice without a test.

  • pain as measured by visual analog scale

Measured

Things only a test, a scale or a device shows.

  • decrease in the hemoglobin level of 2 per deciliter or more

Meaningful

Things that change how a life goes, not only a number.

  • new stroke
  • all cause death
  • death and serious cardiovascular events
  • rate of clinically overt thromboses or vascular death
  • death
  • ischemic stroke
  • hemorrhagic stroke
  • incidence of hospitalization events

A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.

Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.

Measured, but not felt. A number moves. The person notices nothing. Both can be true.

Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.

Matters, but takes years. The result that counts may take longer than anyone would keep watching.

Names that fit none of the three (30)
  • cmax
  • clinically significant hematoma
  • days on anticoagulation
  • adverse events and serious aes
  • major bleed
  • pts assessment completion
  • coronary artery calcium
  • major bleeding event
  • intracranial hemorrhage
  • incidence of major bleeding
  • composite of demographic characteristics age gender and race
  • concomitant treatments relevant active substances
  • risk of thromboembolic event based on the chads2
  • risk of thromboembolic event based on the cha2ds2 vasc
  • risk of bleeding based on the has bled
  • gender
  • race
  • screened who are eligible to participate in the trial
  • eligible who consent to participate in the trial
  • who attend each follow up visit

These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.

What it would be like to takeRead from sources, not yet reviewed

How long anything takes

Nine different lengths of time that get confused with each other. None of them is worked out from another.

  1. Before anything is noticed. RNAWiki does not store this separately, and never works it out from another figure on this page.

  2. Before a test result moves. RNAWiki does not store this separately, and never works it out from another figure on this page.

  3. Before performance moves. RNAWiki does not store this separately, and never works it out from another figure on this page.

  4. How long the result was watched. No finished study window is recorded for a study that tested this substance.

  5. How long people took it. How long people actually took it is not stored. The study window is not the same thing.

  6. How long people were followed. Follow-up length is not stored separately. It is never read off the study window, which would be a different thing.

  7. How fast the body clears it. approximately 12 hours hours

    Read from the label, which states: “Apixaban has a total clearance of approximately 3.3 L/hour and an apparent half-life of approximately 12 hours following oral administration.”

  8. How long effects linger. RNAWiki does not store this separately, and never works it out from another figure on this page.

  9. Beyond the studies. Nothing is recorded about the long term.

    The longest finished study sets the edge of what anyone measured.

A study window is not how long people took it, and neither is how long they were followed. Where RNAWiki holds only one of the three, it shows one.

What is missing or unclearRead from sources, not yet reviewed

Were people like you studied?

RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.

Who was studied

People similar to this profile were included.

  • Very widely used for stroke prevention in non-valvular atrial fibrillation and for venous thromboembolism. It is not an option for mechanical heart valves or moderate-to-severe mitral stenosis.

Who is missing from the studies

  • Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

Who a named study recorded including and excluding

  • It included: Males and females ≥ 18 yrs with atrial fibrillation (AF) and one or more of the following risk factors for stroke:; Age ≥ 75, previous stroke; transient ischemic attack (TIA) or Systemic Embolism (SE); Symptomatic congestive heart failure or left ventricular dysfunction with left ventricular ejection fraction (LVEF) ≤ 40%; Diabetes mellitus or hypertension requiring pharmacological treatment.

    ClinicalTrials.gov record · NCT00412984 · read 2026-08-27

What the label states about particular groups

  • On pediatric, the label states: “Safety and effectiveness in pediatric patients have not been established.”

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

  • On older people, the label states: “Of the total subjects in the ARISTOTLE and AVERROES clinical studies, >69% were 65 years of age and older, and >31% were 75 years of age and older.”

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

  • On people who are pregnant, the label states: “Risk Summary The limited available data on ELIQUIS use in pregnant women are insufficient to inform drug-associated risks of major birth defects, miscarriage, or adverse developmental outcomes.”

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

  • On people who are breastfeeding, the label states: “Risk Summary There are no data on the presence of apixaban or its metabolites in human milk, the effects on the breastfed child, or the effects on milk production.”

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

  • On people with reduced liver function, the label states: “No dose adjustment is required in patients with mild hepatic impairment (Child-Pugh class A).”

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

  • On people with reduced kidney function, the label states: “In patients with ESRD maintained on intermittent hemodialysis, administration of ELIQUIS at the usually recommended dose [see Dosage and Administration (2.1) ] will result in concentrations of apixaban and pharmacodynamic activity similar to those observed in the ARISTOTLE study [see Clinical Pharmacology (12.3) ] .”

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-30

Where the result stopped carrying

  • APPRAISE-2 was terminated after 7,392 patients for increased major bleeding without a counterbalancing ischaemic reduction
  • ADOPT found extended apixaban prophylaxis no more effective than short-course enoxaparin and more likely to cause major bleeding
  • The ischaemic stroke component of ARISTOTLE, the endpoint the drug was designed to change, did not reach significance
  • This is a scope explorer, not a diagnosis engine.
  • It shows who was studied so you can see whether people similar to you were included.

RNAWiki cannot tell whether a study fits you. It can show who was in it.

What it would be like to takeRead from sources, not yet reviewed

Why it might seem to do nothing

A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.

It was studied for a different goal

The studies measured something else entirely.

On this record: Some registered studies measured things that match no goal on this page.

It was studied in different people

The people in the studies were not much like the reader.

On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

The evidence may simply be wrong

Small early studies often do not hold up.

On this record: RNAWiki has not yet published a reviewed conclusion for this use.

Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.

None of these is a reason to take more. Taking more is not a step this page ever suggests.

What it would be like to takeRead from sources, not yet reviewed

What taking it involves

The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.

How it is supplied

Prescription only

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

Read from the recorded approval status.

No source is stored against this line.

Form and route

Oral tablet, twice daily, in two strengths

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form and route recorded on this substance.

No source is stored against this line.

Who oversees it

RNAWiki has not recorded a supervision or regulatory status for this substance.

Quoted from a source

Where this came from

Copied from a source RNAWiki stored, with the source named.

No register row and no identity class settled the question.

No source is stored against this line.

What is in the pack

Twice daily with or without food. No routine coagulation monitoring is used, which removes the burden of the INR clinic and also removes the mechanism that would detect a patient who has stopped taking it. Absorption is dissolution-limited at higher strengths, which is why particle size is a manufacturing specification.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on how this is sold and what that means for what is in the pack.

No source is stored against this line.

Where it is registered

Regulatory records are listed in the technical disclosure at the foot of this page.

Counted from records

Where this came from

A count of rows RNAWiki holds. It describes our records, not your body.

Register entries are stored per jurisdiction and shown with their dates.

No source is stored against this line.

Why people stop

Not recorded.

Nothing recorded

Where this came from

RNAWiki holds nothing here and says so rather than guessing.

No record of why people stopped taking it is stored for this substance.

No source is stored against this line.

What it would be like to takeRead from sources, not yet reviewed

What can go wrong

Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.

Worth asking a clinician aboutWritten into the record from the studies named on this page

The US label carries two boxed warnings: increased risk of thrombotic events including stroke on premature discontinuation, and spinal or epidural haematoma with neuraxial anaesthesia or spinal puncture. Bleeding is the principal risk and is additive with antiplatelet drugs, as APPRAISE-2 demonstrated. Combined strong CYP3A4 and P-glycoprotein inhibitors or inducers change exposure. It is contraindicated in mechanical heart valves.

Nobody counted how many people took this and were fine, so this cannot be turned into a rate.

Where this came from

Reports sent to a regulator

  • These are reports people sent to a regulator. They do not show the medicine caused the reaction.
  • Nobody counted how many people took the medicine and reported nothing.
  • The same event can be reported more than once, and many reports are incomplete.
  • News coverage, lawsuits and new warnings change how often people report.
  • A count is not a rate and not a risk.

Apixaban appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 11556 reaction mentions were counted. One report can name several reactions.

The recorded terms (10)
  • gastrointestinal haemorrhage — 1943 reaction mentions
  • fall — 1514 reaction mentions
  • cerebrovascular accident — 1442 reaction mentions
  • haemorrhage — 1358 reaction mentions
  • anaemia — 1317 reaction mentions
  • atrial fibrillation — 896 reaction mentions
  • deep vein thrombosis — 841 reaction mentions
  • epistaxis — 797 reaction mentions
  • renal impairment — 734 reaction mentions
  • cerebral haemorrhage — 714 reaction mentions
  • open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot

Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.

Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.

What is missing or unclearRead from sources, not yet reviewed

Does the exact form matter?

Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.

The form that was studied

Oral tablet, twice daily, in two strengths

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

The form used in the studies cited on this page.

No source is stored against this line.

What is sold

No routine coagulation monitoring is used, which removes the burden of the INR clinic and also removes the mechanism that would detect a patient who has stopped taking it. Absorption is dissolution-limited at higher strengths, which is why particle size is a manufacturing specification.

Source-linked record

Where this came from

A person wrote this into the record with the study named beside it. No reviewer has signed it off.

Recorded notes on which forms are sold and how they compare.

No source is stored against this line.

What is recorded as being sold

  • 68 products list this as an active ingredient in the United States drug directory. 68 of them contain it and nothing else.

    FDA National Drug Code directory · 71610-662 · read 2026-08-29

  • They are sold as capsule, powder, tablet, film coated and tablet, for suspension, taken oral.

    FDA National Drug Code directory · 71610-662 · read 2026-08-29

  • The regulator's established pharmacologic class for it is factor xa inhibitor [epc] and factor xa inhibitors [moa].

    FDA National Drug Code directory · 71610-662 · read 2026-08-29

  • 11 published labels name it as an active ingredient. 11 of them describe this substance alone, which is where its own label text on this page comes from.

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-29

  • Those labels are classed as human prescription drug.

    US prescribing information · 33a9046a-41cc-46c1-becc-2ff4d7d71538 · read 2026-08-29

  • Apixaban is tablets (film coated) at 2.5 mg and 5 mg, recorded as prescription product; fda label in effect 2021-06-15 in the United States.

    US prescribing information · 095a08ac-cf0e-497e-a682-ddef38d6b29c · read 2026-08-27

Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.

What it would be like to takeRead from sources, not yet reviewed

What you could measure

This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.

RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.

Questions worth asking

  • Which of the trials of Apixaban studied people like me?
  • What was measured, and for how long?
  • Was the result a laboratory value or a health outcome?
  • What would we watch for, and when would we stop?

Tracking can show whether something changed for you. It cannot show what caused it.

RNAWiki records evidence. It does not say whether this substance is right for you.

What is missing or unclearRead from sources, not yet reviewed

Claims that go past the evidence

Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.

Goes past the evidence

That apixaban prevents thromboembolic stroke better than warfarin — ischaemic stroke gave a hazard ratio of 0.92 with p=0.42

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

Goes past the evidence

That a drug superior to warfarin in atrial fibrillation will help in adjacent settings — APPRAISE-2 and ADOPT both failed, one of them stopped early for harm

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

Goes past the evidence

That anticoagulating device-detected brief atrial fibrillation is straightforwardly beneficial — ARTESIA prevented about 5 strokes and caused about 8 major bleeds per 1,000 patient-years

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

Goes past the evidence

That apixaban is superior to rivaroxaban — no randomised head-to-head trial exists

Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.

The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.

What would change this

A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.

RNAWiki has not yet published a reviewed conclusion for this use.

What is missing or unclearRead from sources, not yet reviewed

What nobody knows yet

Open questions, each with why it is open and what would close it.

Missing populations

Which groups were under-represented in the studies has not been recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing long-term data

No completed tested study window is recorded.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

No reviewed conclusion

RNAWiki has not yet published a reviewed conclusion for this use.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Missing interaction studies

No interaction was found in the registers checked. Not finding one is not the same as showing there is none.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Formulation uncertainty

Several salts, forms or products of Apixaban are recorded. Results from one form may not transfer to another.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

Mechanism not reviewed

No reviewed mechanism story exists for this substance.

Why it matters. Recorded by the evidence model as a gap on this record.

What would answer it

A study that measures it, and a reviewer to sign it off.

Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.

What happened in peopleRead from sources, not yet reviewed

Check any of this yourself

Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.

Every line above can be traced to the study named beside it. Follow the link and read it.

ARISTOTLE: better than warfarin on stroke, bleeding and death simultaneously
In plain words
Eighteen thousand patients with atrial fibrillation were randomised to apixaban or well-managed warfarin. Apixaban produced fewer strokes, less major bleeding and fewer deaths — all three at once, which is unusual.
What was measured
Annual rates of stroke or systemic embolism, major bleeding and all-cause death, apixaban versus warfarin
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
ARISTOTLE randomised 18,201 patients with atrial fibrillation and at least one additional stroke risk factor to apixaban 5 mg twice daily or warfarin targeted to an INR of 2.0 to 3.0, median follow-up 1.8 years, designed as a non-inferiority trial with prespecified superiority testing. Stroke or systemic embolism occurred at 1.27% per year against 1.60%: hazard ratio 0.79 (95% CI 0.66 to 0.95), p<0.001 for non-inferiority and p=0.01 for superiority. Major bleeding was 2.13% against 3.09% per year (0.69, 0.60 to 0.80, p<0.001). Death from any cause was 3.52% against 3.94% (0.89, 0.80 to 0.99, p=0.047). Haemorrhagic stroke was 0.24% against 0.47% per year (0.51, 0.35 to 0.75, p<0.001), while ischaemic or uncertain-type stroke was 0.97% against 1.05% (0.92, 0.74 to 1.13, p=0.42).
Source
Granger CB et al., ARISTOTLE, N Engl J Med 2011;365:981-992 (NCT00412984)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
The superiority came from bleeding into the brain, not from preventing clots better
In plain words
Break the stroke result apart and the difference is almost entirely haemorrhagic stroke. Ischaemic strokes — the kind caused by a clot — were not significantly reduced.
What was measured
That apixaban prevents thromboembolic stroke more effectively than warfarin — the ischaemic stroke hazard ratio was 0.92 with p=0.42, and the composite was carried by haemorrhagic stroke
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
In ARISTOTLE, haemorrhagic stroke occurred at 0.24% per year on apixaban against 0.47% on warfarin, hazard ratio 0.51 (95% CI 0.35 to 0.75), p<0.001 — a halving. Ischaemic or uncertain-type stroke occurred at 0.97% against 1.05%, hazard ratio 0.92 (0.74 to 1.13), p=0.42, which does not exclude no effect. Since the primary endpoint pooled both, the headline superiority is driven by the haemorrhagic component. Mechanistically that is coherent: both drugs prevent thromboembolic stroke, and apixaban causes less intracranial bleeding, so an endpoint that counts both kinds of stroke together favours the drug that bleeds less. It matters for interpretation because "apixaban prevents more strokes" and "apixaban causes fewer brain bleeds" are different statements and only the second is clearly demonstrated.
Source
Granger CB et al., ARISTOTLE, N Engl J Med 2011;365:981-992
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
APPRAISE-2: stopped early for bleeding with no ischaemic benefit at all
In plain words
Adding apixaban on top of antiplatelet drugs after an acute coronary syndrome tripled major bleeding and prevented nothing. The trial was halted after 7,392 patients.
What was measured
Cardiovascular death, myocardial infarction or ischaemic stroke, and TIMI major bleeding, at a median 241 days
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
APPRAISE-2 randomised patients with a recent acute coronary syndrome and at least two additional risk factors to apixaban 5 mg twice daily or placebo on top of standard antiplatelet therapy. The trial was terminated prematurely after 7,392 patients because of increased major bleeding without a counterbalancing reduction in ischaemic events. At a median 241 days the primary outcome of cardiovascular death, myocardial infarction or ischaemic stroke occurred in 279 of 3,705 (7.5%, 13.2 per 100 patient-years) on apixaban against 293 of 3,687 (7.9%, 14.0 per 100 patient-years): hazard ratio 0.95 (95% CI 0.80 to 1.11), p=0.51. TIMI major bleeding occurred in 46 of 3,673 (1.3%, 2.4 per 100 patient-years) against 18 of 3,642 (0.5%, 0.9 per 100 patient-years): hazard ratio 2.59 (1.50 to 4.46), p=0.001, with more intracranial and fatal bleeding on apixaban.
Source
Alexander JH et al., APPRAISE-2, N Engl J Med 2011;365:699-708 (NCT00831441)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
ADOPT: extended prophylaxis in medical inpatients was not superior and bled more
In plain words
Thirty days of apixaban after a medical hospital admission was tested against a shorter course of an injected drug. It prevented no more clots and caused more major bleeding.
What was measured
Thirty-day composite venous thromboembolism outcome and major bleeding, extended apixaban versus short-course enoxaparin
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
ADOPT randomised 6,528 acutely ill medical inpatients with heart failure, respiratory failure or another qualifying disorder plus a venous thromboembolism risk factor and an expected stay of at least 3 days, to apixaban 2.5 mg twice daily orally for 30 days or enoxaparin 40 mg subcutaneously once daily for 6 to 14 days. Of 4,495 evaluable for the primary efficacy outcome, the 30-day composite of venous-thromboembolism-related death, pulmonary embolism, symptomatic deep-vein thrombosis or asymptomatic proximal-leg thrombosis on systematic ultrasonography occurred in 2.71% (60 patients) on apixaban against 3.06% (70 patients) on enoxaparin: relative risk 0.87 (95% CI 0.62 to 1.23), p=0.44. Major bleeding by day 30 occurred in 0.47% (15 of 3,184) against 0.19% (6 of 3,217): relative risk 2.58 (1.02 to 7.24), p=0.04.
Source
Goldhaber SZ et al., ADOPT, N Engl J Med 2011;365:2167-2177 (NCT00457002)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
AMPLIFY: same efficacy as warfarin in venous thromboembolism with a third of the bleeding
In plain words
For treating clots in the legs and lungs, a fixed-dose oral regimen matched injections plus warfarin for effectiveness and caused about a third as much major bleeding.
What was measured
Recurrent venous thromboembolism or related death, and major bleeding, over 6 months
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
AMPLIFY randomised 5,395 patients with acute venous thromboembolism to apixaban 10 mg twice daily for 7 days then 5 mg twice daily for 6 months, or to conventional therapy with subcutaneous enoxaparin followed by warfarin. Recurrent symptomatic venous thromboembolism or related death occurred in 59 of 2,609 (2.3%) against 71 of 2,635 (2.7%): relative risk 0.84 (95% CI 0.60 to 1.18), risk difference -0.4 percentage points (-1.3 to 0.4), meeting non-inferiority at p<0.001 for both prespecified margins. Major bleeding occurred in 0.6% against 1.8%: relative risk 0.31 (0.17 to 0.55), p<0.001 for superiority. Major plus clinically relevant non-major bleeding was 4.3% against 9.7%: relative risk 0.44 (0.36 to 0.55), p<0.001. Other adverse events were similar.
Source
Agnelli G et al., AMPLIFY, N Engl J Med 2013;369:799-808 (NCT00643201)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
ARTESIA: in subclinical atrial fibrillation, fewer strokes and more bleeds
In plain words
Brief episodes of irregular heartbeat picked up by an implanted device present a genuine trade. Anticoagulating them prevented about five strokes per thousand patient-years and caused about eight extra major bleeds.
What was measured
Stroke or systemic embolism and major bleeding per patient-year over a mean 3.5 years
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
ARTESIA randomised 4,012 patients with device-detected subclinical atrial fibrillation lasting 6 minutes to 24 hours, mean age 76.8 years, mean CHA2DS2-VASc 3.9, 36.1% women, to apixaban 5 mg twice daily (2.5 mg where indicated) or aspirin 81 mg daily in a double-blind double-dummy design. After a mean 3.5 years, stroke or systemic embolism occurred in 55 patients on apixaban (0.78% per patient-year) against 86 on aspirin (1.24%): hazard ratio 0.63 (95% CI 0.45 to 0.88), p=0.007. In the on-treatment population, major bleeding was 1.71% per patient-year against 0.94%: hazard ratio 1.80 (1.26 to 2.57), p=0.001. Fatal bleeding occurred in 5 patients on apixaban and 8 on aspirin. The absolute stroke reduction is smaller than the absolute bleeding increase, and which matters more depends on the relative severity attached to each.
Source
Healey JS et al., ARTESIA, N Engl J Med 2024;390:107-117 (NCT01938248)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
AVERROES: against aspirin the trade is one-sided, and the trial was stopped early
In plain words
In people who could not take warfarin, apixaban cut strokes by more than half against aspirin without a significant increase in major bleeding. The monitoring board stopped the trial.
What was measured
Stroke or systemic embolism per year, and major bleeding, apixaban versus aspirin
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
AVERROES randomised 5,599 patients with atrial fibrillation at increased stroke risk for whom vitamin K antagonist therapy was unsuitable to apixaban 5 mg twice daily or aspirin 81 to 324 mg daily; 40% had previously used a vitamin K antagonist. The data and safety monitoring board recommended early termination for clear benefit. Over a mean 1.1 years, stroke or systemic embolism occurred in 51 patients on apixaban (1.6% per year) against 113 on aspirin (3.7% per year): hazard ratio 0.45 (95% CI 0.32 to 0.62), p<0.001. Death was 3.5% against 4.4% per year (0.79, 0.62 to 1.02, p=0.07). Major bleeding was 1.4% against 1.2% per year (1.13, 0.74 to 1.75, p=0.57), with 11 intracranial bleeds on apixaban and 13 on aspirin. First cardiovascular hospitalisation fell from 15.9% to 12.6% per year (p<0.001).
Source
Connolly SJ et al., AVERROES, N Engl J Med 2011;364:806-817 (NCT00496769)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim

How many documents were read

  • 11 documents were read for this substance.

    RNAWiki source record

  • 11 of them state the same halfLife, and they agree.

    RNAWiki source record

  • 11 of them state the same bioavailability, and they agree.

    RNAWiki source record

  • 11 of them state the same proteinBinding, and they agree.

    RNAWiki source record

  • 11 of them state the same volumeOfDistribution, and they agree.

    RNAWiki source record

Where else this substance is registered

FDA substance identifier (UNII)
3Z9Y7UWC1J
CAS registry number
503612-47-3
PubChem compound
10182969
RxNorm concept
1364430

Checks this page had to pass

  • Passed

    Identity resolved

    no open identity hold

  • Passed

    No unresolved merge across substance families

    no quarantine open

  • Passed

    Every public sentence names a source

    The opening statement carries the origin: Written into the record, not signed off.

  • Not passed

    Trial roles classified for highlighted evidence

    No registered study is classified as testing this substance.

  • Passed

    No internal keys in reader text

    enforced by the copy-contract test over the rendered page

  • Not passed

    Safety mode resolved

    No register row and no identity class settled the question.

  • Passed

    Canonical metadata present

    slug and display name present

What is missing or unclearRead from sources, not yet reviewed

How this medicine reached us

Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.

What the approval register records

  • 26 approved applications cover products containing this substance. The earliest was NDA202155, approved 20121228 to BRISTOL MYERS SQUIBB.

    Drugs@FDA application register · NDA202155 · read 2026-08-29

  • Marketing status on the register: discontinued, none (tentative approval) and prescription.

    Drugs@FDA application register · NDA202155 · read 2026-08-29

  • The earliest marketing start date recorded for a listed product is 20121228.

    FDA National Drug Code directory · 71610-662 · read 2026-08-29

What is missing or unclearRead from sources, not yet reviewed

What to learn next

Ordered by what would most change how you read this page, starting with what is easiest to misunderstand.

This order is fixed in code and does not count clicks or time on the page.

What is not here

3 questions this page could not answer

These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.

  • What it may clash with — found nothing in the sources checked.
  • Other ways to the same goal — found nothing in the sources checked.
  • What changed on this page — found nothing in the sources checked.

The record as stored

The full record, for auditing

Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.

The older medicine-wide conclusion held in this record

Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.

A direct factor Xa inhibitor that reduced stroke, major bleeding and all-cause death against warfarin in 18,201 patients simultaneously — a result no other anticoagulant has produced — while in 7,392 patients after acute coronary syndrome it raised major bleeding 2.6-fold with a hazard ratio of 0.95 for ischaemic events, and that trial was stopped early.

Recorded evidence blocks (13)

What did Apixaban's largest trial (2140403 people) and its longest (12 years) measure?


2140403 people in Apixaban's largest registered study, 12 years in its longest registered window, measuring Percentage of Participants With Symptomatic and Asymptomatic Recurrent Venous Thromboembolism (VTE) and VTE-Related Mortality. ClinicalTrials.gov · 2026-09-01

77 na or unstated, 68 phase3, 54 phase4, 42 phase2, 31 phase1, 18 na, 3 early phase1; NCT03642509; 2030-10-01. Last human test completed 2026, NCT04618913.

Interpretation These counts include studies where Apixaban was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.

Show the evidence
  • na or unstated
    77
  • phase3
    68
  • phase4
    54
  • phase2
    42
  • phase1
    31
  • na
    18
2 more recorded rows
  • early phase1
    3
  • Last recorded human test NCT04618913
    2026-06-22

recorded 2026-09-01 · last checked 2026-09-04

Apixaban was tested only in human — what did it show?


human: lifespan (287): the rungs where Apixaban has a recorded finding. Europe PMC and ClinicalTrials.gov · organism ladder · 2026-09-01

Interpretation Percentage of Participants With Symptomatic and Asymptomatic Recurrent Venous Thromboembolism (VTE) and VTE-Related Mortality — the recorded outcome words.

Yeast C. elegans Drosophila Mouse Rat Dog Non-human primate Human lifespan
Show the evidence
  • human NCT02464969
    lifespan; Percentage of Participants With Symptomatic and Asymptomatic Recurrent Venous Thromboembolism (VTE) and VTE-Related Mortality; 287

recorded 2026-09-01 · last checked 2026-09-04

28 of Apixaban's trials stopped: safety, futility/efficacy, accrual/recruitment, funding/business, sponsor decision unspecified, other?


safety (3), futility/efficacy (1), accrual/recruitment (11), funding/business (4), sponsor decision unspecified (1) and other (8): Apixaban's stop wording, clustered. ClinicalTrials.gov · 2026-09-01

"See termination reason in detailed description."; 28 of 287 registered studies

Show the evidence

Trial

  • NCT00852397
    terminated; "See termination reason in detailed description."
  • NCT02153424
    withdrawn; "Business objectives have changed."
  • NCT02179177
    terminated; "funding has been exhausted"
  • NCT02378623
    withdrawn; "Sponsor withdrew funding - May 2016"
  • NCT02664155
    terminated; "recruiting difficulties"
  • NCT02749617
    terminated; "Study was stopped due to lack of enrollment."
14 further recorded trials
  • NCT02945280
    terminated; "COVID-19 resource allocation"
  • NCT03136510
    terminated; "not enough patients"
  • NCT03192215
    terminated; "The DSMB halted the trial prematurely due to futility without any safety concerns."
  • NCT03196349
    terminated; "Lack of enrollment"
  • NCT03200613
    terminated; "study not feasible due to too slow recruitment"
  • NCT03398434
    withdrawn; "Trial cancelled before First Patient First Visit (no patient enrolled)"
  • NCT03465735
    terminated; "Due to lack of recruitment of eligible participants"
  • NCT03590743
    terminated; "Lack of participant enrollment"
  • NCT03594045
    terminated; "Withdrawal of funding by sponsor"
  • NCT03678506
    terminated; "The study was interrupted after a planned interim analysis for the high rate of primary outcomes (7.3%; 95% confidence interval \[CI\], 4.5-11.2)"
  • NCT03715725
    terminated; "After feasibility assessment and due to delays in data receipt study was terminated"
  • NCT03839355
    terminated; "Study terminated due to slower than anticipated enrollment."
  • NCT03988842
    terminated; "COVID-19 pandemic"
  • NCT04002011
    withdrawn; "Submission process abandoned. No patient enrolled."

recorded 2026-09-01 · last checked 2026-09-04

Human studies of Apixaban used Apixaban 5 MG Oral Tablet [ELIQUIS] — over how long?


Human studies of Apixaban used "Apixaban 5 MG Oral Tablet [ELIQUIS]". ClinicalTrials.gov · 2026-09-01

20 recorded entries; human; also "Apixaban 5 MG", "Apixaban 10 MG", "Apixaban 5 mg"

Show the evidence

human

  • NCT02982590
    Apixaban 5 MG Oral Tablet [ELIQUIS]
  • NCT03083704
    Apixaban 5 MG
  • NCT03083704
    Apixaban 10 MG
  • NCT03136510
    Apixaban 5 mg
  • NCT03196349
    Apixaban 2.5 MG
  • NCT03243175
    ELIQUIS 5mg
14 more recorded rows
  • human NCT03251482
    Apixaban 2.5 mg
  • human NCT04243122
    Apixaban 2.5 MG Oral Tablet [ELIQUIS]
  • human NCT04498273
    Apixaban 5MG
  • human NCT04504318
    Apixaban 2.5 MG Oral Tablet
  • human NCT04666454
    Apixaban 5 mg Oral Tablet
  • human NCT04696120
    apixaban 5mg or 2.5mg bid
  • human NCT04874428
    Apixaban 2.5 mg Oral Tablet
  • human NCT04981327
    Apixaban 5 MG Oral Tablet
  • human NCT05723510
    Apixaban 5mg
  • human NCT05723510
    Eliquis Tab. 5 mg
  • human NCT06043297
    Eliquis 5 mg
  • human NCT06523959
    Eliquis 2,5mg
  • human NCT06689436
    5 mg Apixaban Oral Dissolving Film (fasting)
  • human NCT06689436
    5 mg Apixaban Oral Dissolving Film (fed)

recorded 2026-09-01 · last checked 2026-09-04

Apixaban's half-life is approximately 12 hours — which schedules were studied?


approximately 12 hours, the half-life Apixaban's label states. openfda-label · a454cd24-0c6d-46e8-b1e4-197388606175 · 2026-08-27

bioavailability approximately 50% %.

Show the evidence
  • half life
    approximately 12 hours hours; Apixaban has a total clearance of approximately 3.3 L/hour and an apparent half-life of approximately 12 hours following oral administration.
  • bioavailability
    approximately 50% %; The absolute bioavailability of apixaban is approximately 50% for doses up to 10 mg of apixaban.
  • metabolism
    Metabolism Approximately 25% of an orally administered apixaban dose is recovered in urine and feces as metabolites.

recorded 2026-08-27 · last checked 2026-09-04

Could one person measure Apixaban's effect on cmax?


Cmax: measured in Apixaban's trials.

Interpretation cmax is the recorded endpoint.

Show the evidence

biomarkers

  • cmax; 2026-09-01
  • clinically significant hematoma; 2026-09-01
  • days on anticoagulation; 2026-09-01
  • adverse events and serious aes; 2026-09-01
  • new stroke; 2026-09-01
  • major bleed; 2026-09-01
14 more recorded rows
  • biomarkers
    pts assessment completion; 2026-09-01
  • biomarkers
    coronary artery calcium; 2026-09-01
  • biomarkers
    major bleeding event; 2026-09-01
  • biomarkers
    all cause death; 2026-09-01
  • biomarkers
    pain as measured by visual analog scale; 2026-09-01
  • biomarkers
    death and serious cardiovascular events; 2026-09-01
  • biomarkers
    intracranial hemorrhage; 2026-09-01
  • biomarkers
    rate of clinically overt thromboses or vascular death; 2026-09-01
  • biomarkers
    incidence of major bleeding; 2026-09-01
  • biomarkers
    decrease in the hemoglobin level of 2 per deciliter or more; 2026-09-01
  • biomarkers
    composite of demographic characteristics age gender and race; 2026-09-01
  • biomarkers
    concomitant treatments relevant active substances; 2026-09-01
  • biomarkers
    risk of thromboembolic event based on the chads2; 2026-09-01
  • biomarkers
    risk of thromboembolic event based on the cha2ds2 vasc; 2026-09-01
  • half life
    2026-09-04; halfLife; hours; approximately 12 hours; 2026-08-27
  • human trials at or under30
    46
  • smallest human trial
    0; NCT02153424; NA_OR_UNSTATED; the smallest recorded human enrolment at or below 30; the registry states no direction of its result; WITHDRAWN

Which of adverse events and serious aes, all cause death and clinically significant hematoma did Apixaban's trials measure?


adverse events and serious aes, all cause death and clinically significant hematoma lead 40 outcome terms across Apixaban's trials. ClinicalTrials.gov · 2026-09-01

Interpretation adverse events and serious aes, new stroke, major bleed, pts assessment completion, coronary artery calcium and major bleeding event follow.

Show the evidence
  • cmax
    1
  • clinically significant hematoma
    1
  • days on anticoagulation
    1
  • adverse events and serious aes
    1
  • new stroke
    1
  • major bleed
    1
14 more recorded rows
  • pts assessment completion
    1
  • coronary artery calcium
    1
  • major bleeding event
    1
  • all cause death
    1
  • pain as measured by visual analog scale
    1
  • death and serious cardiovascular events
    1
  • intracranial hemorrhage
    1
  • rate of clinically overt thromboses or vascular death
    1
  • incidence of major bleeding
    1
  • decrease in the hemoglobin level of 2 per deciliter or more
    1
  • composite of demographic characteristics age gender and race
    1
  • concomitant treatments relevant active substances
    1
  • risk of thromboembolic event based on the chads2
    1
  • risk of thromboembolic event based on the cha2ds2 vasc
    1

recorded 2026-09-01 · last checked 2026-09-04

Which of Apixaban's 68 ongoing trials reports first?


68 registered trials of Apixaban are open; earliest completion 2025-11-01. ClinicalTrials.gov · 2026-09-01

Primary efficacy outcome: A composite endpoint of stroke, myocardial infarction, thromboembolic event or all-cause death.; Primary efficacy outcome: a composite endpoint of new venous thromboembolism or all-cause death.; latest 2033-10-03

Show the evidence

Trial

  • NCT03129490
    "The Danish Non-vitamin K Antagonist Oral Anticoagulation Study in Patients With Atrial Fibrillation"; n 11000; "Primary efficacy outcome: A composite endpoint of stroke, myocardial infarction, thromboembolic event or all-cause death."; 2027-10-30
  • NCT03129555
    "The Danish Non-vitamin K Antagonist Oral Anticoagulation Study in Patients With Venous Thromboembolism (DANNOAC-VTE)"; n 5000; "Primary efficacy outcome: a composite endpoint of new venous thromboembolism or all-cause death."; 2029-03-31
  • NCT03243175
    "Avoiding Anticoagulation After IntraCerebral Haemorrhage"; n 300; "Composite of all fatal or non-fatal major cardiovascular/cerebrovascular ischaemic or haemorrhagic intracranial/extracranial events"; 2029-12
  • NCT03448783
    "Bariatric Surgery and Pharmacokinetics of Apixaban"; n 12; "Apixaban concentration in blood serum (area under curve (AUC))"; 2026-12
  • NCT03642509
    "Left Atrial Appendage Occlusion Versus Novel Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation"; n 750; "Composite endpoint of stroke (ischemic and hemorrhagic), systemic embolism, major bleeding and all-cause mortality."; 2030-10-01
  • NCT03907046
    "Anticoagulation in ICH Survivors for Stroke Prevention and Recovery"; n 700; "Stroke or death"; 2027-04
14 further recorded trials
  • NCT03968393
    "Anticoagulation for Stroke Prevention In Patients With Recent Episodes of Atrial Fibrillation Occurring Transiently With Stress"; n 2270; "Incidence of Non-hemorrhagic stroke or systemic embolism"; 2028-12
  • NCT04007289
    "Apixaban for Intrahepatic Non Cirrhotic Portal Hypertension"; n 166; "Portal venous system thrombosis"; 2026-12-31
  • NCT04262492
    "International Registry of Thrombotic APS Patients Treated With Direct Oral Anticoagulants"; n 500; "Rate of Recurrent Thrombosis"; 2031-04-21
  • NCT04284839
    "The Direct Oral Anticoagulation Versus Vitamin K Antagonist After Cardiac Surgery Trial"; n 3500; "Major Bleeding"; 2027-06
  • NCT04642430
    "COmparison of Bleeding Risk Between Rivaroxaban and Apixaban in Patients With Atrial Fibrillation"; n 3018; "The rate of adjudicated clinically relevant bleeding (CRB) events"; 2027-12-31
  • NCT04666454
    "BROKEN-SWEDEHEART- Optimized Pharmacological Treatment for Broken Heart (Takotsubo) Syndrome."; n 1000; "Randomization 1: First co-primary endpoint: Wall motion score index (defined as the semi-quantitative score according to the American Society of Echocardiography)"; 2028-12
  • NCT04700826
    "Preventing Stroke, Premature Death and Cognitive Decline in a Broader Community of Patients With Atrial Fibrillation"; n 3000; "Composite primary endpoint - Time to first event"; 2031-01
  • NCT04874428
    "Direct Oral Anticoagulants (Rivaroxaban and Apixaban) in Patients With Liver Cirrhosis"; n 24; "Area under the plasma concentration-time curve (AUC) of rivaroxaban"; 2026-12
  • NCT04981327
    "The API-CALF Study: Apixaban to Treat Calf Vein Thrombosis"; n 1300; "Rate of i) symptomatic VTE; ii) major bleeding and clinically relevant non major bleeding (CRNMB); iii) VTE and bleeding related death."; 2027-08-31
  • NCT05187286
    "Expanded Access for Apixaban"
  • NCT05198960
    "AVAJAK: Apixaban/Rivaroxaban Versus Aspirin for Primary Prevention of Thrombo-embolic Complications in JAK2V617F-positive Myeloproliferative Neoplasms"; n 1308; "Time to occurrence of arterial or venous thromboembolic events."; 2027-07-13
  • NCT05484557
    "Prevention of Thromboembolism Using Apixaban vs Enoxaparin Following Spinal Cord Injury"; n 60; "Number of participants with venous thromboembolism (VTE)"; 2026-02
  • NCT05498428
    "A Study of Amivantamab in Participants With Advanced or Metastatic Solid Tumors Including Epidermal Growth Factor Receptor (EGFR)-Mutated Non-Small Cell Lung Cancer"; n 520; "All Cohorts Except Cohort 4: Objective Response Rate (ORR) Based on Investigator Assessment (INV)"; 2028-08-18
  • NCT05683808
    "Venous Thromboembolism Prevention in Outpatients With Glioma"; n 40; "Safety of apixaban as determined by bleeding risk"; 2027-06-30

recorded 2026-09-01 · last checked 2026-09-04

Which running trial of Apixaban could settle lifespan?


NCT06370273 measures Composite of net clinical benefit comprising clinical VTE event, major bleeding, and cause-specific mortality, reading out 2028-08-31.

3 open trials; n 10044; "Thromboprophylaxis in Lower Limb Immobilisation"

Show the evidence

Trial

  • NCT06370273
    "Thromboprophylaxis in Lower Limb Immobilisation"; n 10044; "Composite of net clinical benefit comprising clinical VTE event, major bleeding, and cause-specific mortality"; 2028-08-31
  • NCT07471139
    "SWITCH: Apixaban vs Vitamin K in HM3"; n 460; "Survival free of major hemocompatibility related adverse event"; 2029-08
  • NCT03642509
    "Left Atrial Appendage Occlusion Versus Novel Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation"; n 750; "Composite endpoint of stroke (ischemic and hemorrhagic), systemic embolism, major bleeding and all-cause mortality."; 2030-10-01

Which 89 trials of Apixaban posted no result?


Posted no result
89 of 89 completed trials
Registrations
NCT00097357, NCT02262520, NCT00252005, NCT02262533, NCT01437839 and NCT02792335, and 83 more
Completion dates
oldest 2005-12; newest 2024-06-15
Show the evidence

Trial

  • NCT00097357
    2005-12
  • NCT02262520
    2006-03
  • NCT00252005
    2007-02
  • NCT02262533
    2007-06
  • NCT01437839
    2011-10
  • NCT02792335
    2014-08
14 further recorded trials
  • NCT02270918
    2014-12
  • NCT02833987
    2015-03
  • NCT01885585
    2015-05
  • NCT02345343
    2015-10-07
  • NCT02769078
    2016-02
  • NCT02470767
    2016-03
  • NCT02559232
    2016-03
  • NCT02687854
    2016-03-01
  • NCT02066454
    2016-07-12
  • NCT02672709
    2016-08
  • NCT02007655
    2016-08-31
  • NCT02912234
    2016-10
  • NCT02607371
    2016-10-15
  • NCT03568916
    2016-11

At the median, Apixaban's trials enrolled 300 people — anything larger?


Median enrolment
300
Largest enrolment
2140403
Registered trials counted
286

What do 11556 spontaneous reports say about Apixaban — and not say?


These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.

Apixaban appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 11556 reaction mentions were counted: gastrointestinal haemorrhage 1943; fall 1514; cerebrovascular accident 1442; haemorrhage 1358. open-targets-adr · CHEMBL231779 · 2026-06-24

Show the evidence
  • gastrointestinal haemorrhage
    1943
  • fall
    1514
  • cerebrovascular accident
    1442
  • haemorrhage
    1358
  • anaemia
    1317
  • atrial fibrillation
    896
4 more recorded rows
  • deep vein thrombosis
    841
  • epistaxis
    797
  • renal impairment
    734
  • cerebral haemorrhage
    714

recorded 2026-06-24 · last checked 2026-09-04

Apixaban and CYP1A2, CYP3A4 and P-GP: shared by which compounds?


CYP1A2, CYP3A4 and P-GP appear in Apixaban's recorded interaction sentences, 10 in all. openfda-label+europepmc · 2026-08-30

Interpretation pharmacokinetics

Show the evidence

CYP1A2

  • pharmacokinetics
    Apixaban is metabolized mainly via CYP3A4 with minor contributions from CYP1A2, 2C8, 2C9, 2C19, and 2J2.
  • pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.
  • CYP2A6 pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.
  • CYP2B6 pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.
  • CYP2C19 pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.
  • CYP2C8 pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.
  • CYP2C9 pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.
  • CYP2D6 pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.

CYP3A4

  • pharmacokinetics
    Apixaban is metabolized mainly via CYP3A4 with minor contributions from CYP1A2, 2C8, 2C9, 2C19, and 2J2.
  • pharmacokinetics
    Drug Interaction Studies In i n vitro apixaban studies at concentrations significantly greater than therapeutic exposures, no inhibitory effect on the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6, CYP3A4/5, or CYP2C19, nor induction effect on the activity of CYP1A2, CYP2B6, or CYP3A4/5 were observed.

recorded 2026-08-30 · last checked 2026-09-04

Where it is registered
Identifiers, relations and other names

The exact record

ChEMBL id
CHEMBL231779
PubChem CID
10203943
CAS number
503612-76-8
RxCUI
1364430
InChIKey
QNZCBYKSOIHPEH-UHFFFAOYSA-N
Trade name
Apixaban accord, Eliquis, Eliquis Sprinkle, Abanta
Development code
BMS-562247, BMS-562247-01
Salt form
direct oral anticoagulant, direct oral anticoagulants, novel oral anticoagulants
Also called
doac, doacs, noac, noacs, Apixaban [EMA EPAR], Apixaban [INN], Apixaban [JAN], Apixaban [MART.], Apixaban [MI], Apixaban [ORANGE BOOK], Apixaban [USAN], Apixaban [VANDF]
Sources (9)

Sources

3 more sources
  • openfda-label a454cd24-0c6d-46e8-b1e4-197388606175 ·
  • openfda-label+europepmc K1:3Z9Y7UWC1J ·
  • national registers US, EU, CA ·

ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Europe PMC — metadata only, under the recorded legal gate · Open Targets 26.06 — CC0 · derived from this page's own recorded fields; no external licence · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work

How these records are assembled · Which registers were checked

Index-quality checks
  • identity passed: no open identity hold
  • required summary fields resolved: 5 required field(s) not terminal: Why people use it, Best-supported result, Most important common problem, Biggest unanswered question, Human evidence
  • public claims reviewed: 0 reviewed claim(s); drafts are never rendered
  • source coverage passed: 9 source rows
  • no critical contamination: no quarantine open
  • canonical metadata passed: slug and display name present
  • no raw internal fields: enforced by the copy-contract test over the rendered page

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