Apo-Apixaban Adverse Reactions

Summary of the safety profile: Common adverse reactions were haemorrhage, contusion, epistaxis, and haematoma (see Table 15 for adverse reaction profile and frequencies by indication).
In the VTEp studies, in total, 11% of the patients treated with apixaban 2.5 mg twice daily experienced adverse reactions. The overall incidence of adverse reactions related to bleeding with apixaban was 10% in the apixaban vs enoxaparin studies.
In the NVAF studies, the overall incidence of adverse reactions related to bleeding with apixaban was 24.3% in the apixaban vs warfarin study and 9.6% in the apixaban vs acetylsalicylic acid study. In the apixaban vs warfarin study the incidence of ISTH major gastrointestinal bleeds (including upper GI, lower GI, and rectal bleeding) with apixaban was 0.76%/year. The incidence of ISTH major intraocular bleeding with apixaban was 0.18%/year.
In the VTEt studies, the overall incidence of adverse reactions related to bleeding with apixaban was 15.6% in the apixaban vs enoxaparin/warfarin study and 13.3% in the apixaban vs placebo study (see Pharmacology: Pharmacodynamics under Actions).
2.5 mg: The safety of apixaban has been investigated in 7 Phase III clinical studies including more than 21,000 patients: more than 5,000 patients in VTEp studies, more than 11,000 patients in NVAF studies and more than 4,000 patients in the VTE treatment (VTEt) studies, for an average total exposure of 20 days, 1.7 years and 221 days respectively (see Pharmacology: Pharmacodynamics under Actions).
5 mg: The safety of apixaban has been investigated in 4 Phase III clinical studies including more than 15,000 patients: more than 11,000 patients in NVAF studies and more than 4,000 patients in the VTE treatment (VTEt) studies, for an average total exposure of 1.7 years and 221 days respectively (see Pharmacology: Pharmacodynamics under Actions).
Tabulated list of adverse reactions: Table 15 shows the adverse reactions ranked under headings of system organ class and frequency using the following convention: very common ( ≥ 1/10); common ( ≥ 1/100 to < 1/10); uncommon ( ≥ 1/1,000 to < 1/100); rare ( ≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000); not known (cannot be estimated from the available data) for VTEp, NVAF, and VTEt respectively.

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Description of selected adverse reactions: The use of apixaban may be associated with an increased risk of occult or overt bleeding from any tissue or organ, which may result in posthaemorrhagic anaemia. The signs, symptoms, and severity will vary according to the location and degree or extent of the bleeding (see Precautions and Pharmacology: Pharmacodynamics under Actions).
Known complications secondary to severe bleeding such as anticoagulant-related nephropathy has occasionally been reported in patients receiving anticoagulants in the post-marketing setting. In patients with pre-existing kidney disease, ARN may occur, possibly in relation to episodes of excessive anticoagulation and haematuria. The possibility of haemorrhage is to be considered in evaluating the condition in any anticoagulated patient (see Precautions).
Reporting of suspected adverse reactions: Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions.