Eliquis generic: Availability, cost, and dosage

In this article:

• What is Eliquis used for? 
• Is there a generic for Eliquis?
• Is Eliquis covered by insurance?
• Off-labels uses of Eliquis
• Eliquis alternatives

In this article

• What is Eliquis used for? 
• Is there a generic for Eliquis?
• Is Eliquis covered by insurance?
• Off-labels uses of Eliquis
• Eliquis alternatives

Eliquis (apixaban) is a novel oral anticoagulant and, more specifically, a Factor Xa inhibitor that’s used to prevent or treat blood clots. It works by blocking an enzyme called Factor Xa, which is involved in the clotting process. Eliquis was approved by the U.S. Food and Drug Administration (FDA) in 2012 as a brand-name drug. Although a generic was approved in 2019, generic apixaban may not be available on the market until at least April 2028.

What is Eliquis used for? 

Eliquis is approved to:

• Lower the risk of stroke and systemic embolism in people with nonvalvular atrial fibrillation (atrial fibrillation that is not due to a heart valve problem)
• Prevent deep vein thrombosis (DVT; a blood clot in the leg), which can travel to the lungs and cause pulmonary embolism (PE; a blood clot in the lung) in patients who have had hip or knee replacement surgery
• Treat DVT and PE
• Lower the risk of DVT and PE from recurring
• Treat blood clots (venous thromboembolism, VTE) and lower the risk of these clots coming back in children (from birth and older) after they have had at least five days of treatment with another blood thinner

Is there a generic for Eliquis?

Yes, the first generics of apixaban were announced in December 2019. The FDA approved two applications for generic versions of Eliquis by the companies Micro Labs Limited and Mylan Pharmaceuticals, Inc. 

In 2021, the Bristol Myers Squibb-Pfizer Alliance announced that the U.S. Court of Appeals for the Federal Circuit finalized a decision protecting the Eliquis patent and stating that the earliest generic launch of apixaban would be delayed until at least April 1, 2028, “subject to additional appeals and challenges,” and also stating, “We believe in the value of science behind Eliquis and its therapeutic potential for patients, and the underlying intellectual property protecting these innovations.” 

What are the differences between brand-name and generic Eliquis?

Brand-name Eliquis and its generic version, apixaban, contain the same active ingredient and work the same way to treat and prevent blood clots. However, generics may look different in color, shape, or markings due to trademark rules, and they may have different inactive ingredients. The generic would have the same strength and dosage form as the brand, but often at a lower price. 

When you fill a prescription for Eliquis, you will receive a patient information leaflet. Be sure to read all the information carefully and ask your healthcare provider or pharmacist if you have any questions. 

	Eliquis (apixaban)
Uses	Lower the risk of stroke and systemic embolism in people with nonvalvular atrial fibrillation  Prevent DVT and PE in patients who have had hip or knee replacement surgery Treat DVT and PE Lower the risk of DVT and PE from recurring Treat and prevent VTE in infants and children
Standard dosage	2.5 mg or 5 mg by mouth twice daily
Common side effects	Bleeding Anemia  Nausea  Headache
Contraindications (who should NOT take Eliquis)	People who are allergic to apixaban or any ingredient in Eliquis People with major active bleeding Individuals who are pregnant or breastfeeding People with severe liver problems People with certain types of acute PE People with a prosthetic heart valve People with a medical condition called antiphospholipid syndrome
Other considerations	Eliquis has a black box warning, which is the most serious warning required by the FDA. The warning states that prematurely discontinuing Eliquis increases the risk of blood clots.  The warning also states that people taking Eliquis who receive neuraxial anesthesia (such as a spinal or epidural injection) or undergo a spinal puncture may develop epidural or spinal hematomas, or collections of blood in the spinal area. These hematomas have a high risk of long-term or permanent paralysis. Although most serious side effects of Eliquis are related to bleeding, life-threatening allergic reactions could occur in rare cases. Seek emergency medical help if you have hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.  Some medications can change how Eliquis works, either increasing your risk of bleeding or making the drug less effective. Always let your doctor or pharmacist know about all the prescription and over-the-counter medicines or supplements you use.

How much is generic Eliquis?

There is no cost information for generic Eliquis since it’s not available yet on the market. However, according to the manufacturer, brand-name Eliquis costs about $606 for a one-month supply. 

Eliquis prices
Average cost without insurance	$817 for 60, 2.5 mg or 5 mg tablets of Eliquis
SingleCare’s lowest price	$488 for 60, 2.5 mg or 5 mg tablets of Eliquis at Kroger
Free coupons	Eliquis coupons

Is Eliquis covered by insurance?

Eliquis is generally covered by commercial insurance and Medicare plans. However, the price can vary based on several factors, including the condition being treated and the prescribed dosage.

Based on manufacturer data, people with atrial fibrillation who are commercially insured pay an average of $38 per month. For those with Medicare prescription coverage, the average monthly cost is $54.

On the other hand, people with a DVT or PE who are commercially insured pay an average of $33 per month, while those who have Medicare prescription coverage pay an average of $44 per month. Contact your health insurance company for up-to-date cost and coverage information for prescription drugs like Eliquis.

What are the off-label uses for Eliquis? 

Healthcare professionals sometimes prescribe medications for a use that is not FDA-approved, which is called off-label prescribing. For example, Eliquis has been studied for blood clot prevention in people hospitalized with COVID-19, but current guidelines do not recommend it for this purpose due to limited evidence.

Eliquis may also be used off-label for a condition called heparin-induced thrombocytopenia type A (HIT A), a rare blood reaction to heparin. In some stable patients, doctors may use Eliquis or another similar medication instead of injectable blood thinners.

Additionally, some healthcare providers may prescribe Eliquis at doses that differ from those approved by the FDA, a practice known as off-label dosing. For example, some healthcare providers underdose Eliquis, hoping to avoid the side effects of bleeding. However, studies show that underdosing does not reduce the occurrence of bleeding and leads to a higher risk of stroke and clots. 

Generic alternatives to Eliquis

Generic versions and alternative blood thinners are available for people who can’t take Eliquis or want a lower-cost option. Some people may switch due to adverse effects or inadequate insurance coverage. 

Potential Eliquis alternatives include:

• Warfarin (Coumadin) 
• Rivaroxaban (Xarelto)
• Dabigatran (Pradaxa)
• Edoxaban (Savaysa)
• Enoxaparin (Lovenox)
• Fondaparinux (Arixtra)

These alternatives may have similar possible side effects and warnings as Eliquis. Seek medical advice when considering potential alternatives to Eliquis. A healthcare provider can recommend a different drug that’s better for your condition. 

How to switch from Eliquis to an alternative

Switching from Eliquis to another anticoagulant depends on which medication you’re moving to. If you’re switching to warfarin, your doctor may have you stop Eliquis and start both warfarin and a temporary injectable blood thinner at the time you would normally take your next Eliquis dose. Once your INR reaches the right range, the injectable is stopped, and you can continue with warfarin alone.

If you’re switching from Eliquis to another blood thinner, such as Xarelto, Pradaxa, or an injectable option, the change is more straightforward. You can usually stop Eliquis and start the new medication at the scheduled time of your next dose.

What are some ways to stay safe while taking Eliquis?

When taking Eliquis—or any blood thinner—there are some steps you can take to stay as safe as possible:

• Tell your healthcare provider about all medications, including prescriptions, over-the-counter drugs, vitamins, and dietary supplements. Check with your provider before starting anything new. Drug interactions with other blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), and selective serotonin reuptake inhibitors (SSRIs) may increase your risk of bleeding.
• Alcohol can increase the risk of bleeding. Consult your healthcare provider if you regularly drink alcohol.
• If you fall or hit your head—even if you are not bleeding—go to the hospital immediately. You may have internal bleeding or bleeding in the skull, which is a medical emergency.
• Be extra careful with objects that cause bleeding, such as knives, scissors, razors, and other sharp objects. Use an electric razor rather than a manual one.
• Avoid activities and sports that may cause injury. Stick to safer activities, such as swimming and sports. Consult your healthcare provider about your exercise regimen. 
• Use a soft toothbrush and waxed floss to minimize gum irritation. Avoid toothpicks. 
• Wear shoes or non-skid slippers inside your home. Always wear shoes outside.
• Be careful when trimming your toenails. Do not attempt to trim corns and calluses yourself. 
• When working outside, use appropriate gloves for handling sharp tools or working in the yard.

Ask your healthcare provider if there are any other precautions you need to take.

RELATED: How long should you stop Eliquis before surgery? │ What foods to avoid while on Eliquis

Summary

A generic version of Eliquis may not be available until at least April 2028. Until then, continue to take brand-name Eliquis as prescribed. If you need help paying for the cost of your prescription, you can check the manufacturer’s website for savings and support information. You can also use a free SingleCare card or coupon to save money on your Eliquis prescription and refills. In addition, alternative medications are available if cost is a concern.