The NHS has issued a critical warning for individuals taking apixaban, a widely prescribed anticoagulant medication. Users are advised to "call 111" immediately if they observe blood in their urine or stools while using the toilet. This symptom could indicate internal bleeding, a serious side effect that requires urgent medical attention.
What is Apixaban?
Apixaban is an anticoagulant drug commonly used to prevent the formation of dangerous blood clots. If left untreated, these clots can travel to vital organs, leading to strokes, heart attacks, or pulmonary embolisms. Millions of Britons are prescribed anticoagulants each year, either to treat existing clots or as a preventative measure for those at risk. However, like all medications, apixaban can cause side effects.
Common Side Effects
The NHS states: "Like all medicines, apixaban can cause side effects, but not everyone gets them. One of the most common side effects of taking apixaban is bleeding more than usual." This may include:
- Bleeding for longer than usual if you cut yourself
- Nosebleeds
- Bleeding from your gums when you brush your teeth
- Bruises that come up more easily and take longer to fade than usual
- Periods that are heavier and last longer than usual
Other side effects can include anaemia (causing tiredness and pale skin), feeling sick (nausea), or a rash.
Serious Side Effects: Internal Bleeding
The NHS warns: "Apixaban can sometimes cause serious side effects, but most of them are rare. A more common serious side effect is heavy bleeding or internal bleeding." A key indicator is the presence of blood in the toilet—either in urine or stools. The NHS advises calling 111 if you are taking apixaban and notice any signs of bleeding.
Additional warning signs of internal bleeding include:
- Blood in your vomit or coughing up blood
- Bleeding in the brain – sudden bad headache with confusion, sensitivity to light, slurred speech, difficulty moving arms or legs, or feeling or being sick
- Bleeding from a surgical wound after surgery
Other serious side effects may include an allergic reaction (anaphylaxis) causing a swollen throat or tongue, raised itchy rash, or difficulty breathing, and low blood pressure (hypotension) causing lightheadedness, dizziness, tiredness, or a faster heartbeat.
When to Call 111
You should ring NHS 111 if you are taking apixaban and:
- You have symptoms of bleeding
- You have had a head injury
- You think you might be having any other serious side effects
The NHS adds: "You will be given an anticoagulant alert card because apixaban may put you at risk of bleeding. Always carry this with you. Show it to your doctor or dentist before you have any medical or dental procedures."
