Eliquis generic availability, cost, and dosage

Eliquis (apixaban) is a newer anticoagulant, also known as a novel oral anticoagulant, and, more specifically, a Factor Xa inhibitor. It works by blocking an enzyme called Factor Xa involved in the clotting process. 

Eliquis is commonly prescribed to prevent or treat blood clots. As of 2020, it was the 48th most popularly prescribed medication in the United States, with over 3 million Americans filling almost 14 million Eliquis prescriptions. 

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 will not be available on the market until at least April 2028.

What is Eliquis used for? 

Eliquis is FDA approved in adults 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; blood clot in the leg), which can travel to the lungs and cause pulmonary embolism (PE; 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 reoccurring

Is there a generic for Eliquis?

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. 

Generally, people are excited by the news of new generic drugs, as they know they can soon access a lower-cost generic. However, pharmaceutical companies Bristol-Myers Squibb and Pfizer filed lawsuits to delay these generic manufacturers from bringing apixaban generics to the market. 

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 should I know about Eliquis?

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

What is the price of Eliquis?

The manufacturer reports that Eliquis costs about $561 for a one-month supply. With insurance, patients pay an average of $51 per month—with commercially insured patients paying an average of $38 per month and people with Medicare prescription coverage paying an average of $55 per month. You can contact your health insurance plan for up-to-date cost and prescription drug coverage information for Eliquis.

What are the off-label uses for Eliquis? 

Healthcare professionals sometimes prescribe medications for a use that is not FDA-approved. This is called off-label prescribing. 

For example, some healthcare providers underdose Eliquis (known as off-label underdosing), hoping to avoid the side effect of bleeding. However, studies show that underdosing does not reduce the occurrence of bleeding and leads to a 22% higher risk of stroke and clots. 

On the other hand, some healthcare professionals overdose (for example, prescribing a regular dose rather than the recommended reduced dose in people with kidney problems). This is known as off-label overdosing. These cases have led to a 26% increased risk of major bleeding and a 30% higher risk of stroke and clots. 

What are the signs and symptoms of bleeding when taking Eliquis?

Talk to your healthcare provider about what signs and symptoms to look for while taking Eliquis. When taking Eliquis, you may bruise more easily, and it may take longer for bleeding to stop. Some general signs and symptoms of bleeding include:

• Unusually heavy menstrual bleeding
• Red or brown urine
• Red or black bowel movements
• Brown or bright red vomit
• Bleeding from the gums or nose that does not stop quickly
• Coughing up something red
• Severe pain, like a headache or stomach pain
• Unusual bruising
• A cut that does not stop bleeding
• A serious fall or bump on the head, which can cause internal bleeding
• Dizziness
• Weakness

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:

• Make sure your healthcare provider knows about all the medications you take so that they can be aware of any drug interactions. This includes prescription drugs, OTC medicines, vitamins, and supplements. Do not take any new medications until you check with your provider. Certain drugs in combination with Eliquis increase the risk of bleeding, such as aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), SSRI or SNRI antidepressants, and other blood thinners. 
• Alcohol can increase the risk of bleeding, so consult your healthcare provider if you 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.
• 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 like 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 using sharp tools/working in the yard.

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

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 always use a free SingleCare card or coupon to save money on your Eliquis prescription and refills.