Apixaban overdose — what to watch for and what to do right now

Dropping too much apixaban (Eliquis) can be scary because it raises the risk of serious bleeding. If you or someone else might have taken too much, act fast. This guide tells you clear steps to spot trouble, first actions to take, and the treatments doctors use to reverse the drug.

Common signs of overdose

Bleeding is the main sign. Look for: heavy nosebleeds, unusual bruises, blood in urine or stool, coughing or vomiting blood, very heavy menstrual bleeding, severe headache or sudden weakness (could mean bleeding in the brain). Also watch for fainting, dizziness, or fast pulse — these can mean major blood loss. If any of these show up, treat it as an emergency.

What to do immediately

If the person is unconscious, not breathing, or showing signs of major bleeding, call emergency services right away. If they're awake and the overdose is noticed within a few hours of swallowing, bring them to the ER and tell staff the time and amount taken. If you’re in the U.S., you can also call Poison Control at 1-800-222-1222 for advice while you head to care.

If the overdose was within about 2 to 3 hours, emergency staff may consider activated charcoal to reduce further absorption. Don’t try home remedies or induce vomiting — leave those decisions to clinicians.

Bring the pill bottle or packaging to the hospital. That saves time and helps doctors choose the right treatment. Tell them about other meds, recent surgeries, kidney problems, or a history of bleeding.

Apixaban isn’t cleared well by dialysis, so that won’t help much. Treatment focuses on stopping bleeding and reversing the medication’s effect.

In the hospital, doctors may use:

• Andexanet alfa — a specific reversal drug for apixaban and other factor Xa inhibitors. It can reverse anticoagulation quickly when available.
• Four-factor prothrombin complex concentrate (4F-PCC) — used if andexanet isn’t available or as an alternative in urgent cases.
• Supportive care — blood transfusions, fluids, and local measures to control bleeding (stitches, packing, endoscopy or surgery if needed).

If you take apixaban regularly, keep an updated list of all medications and medical conditions. Store pills in their original container and follow dosing exactly. If you miss a dose, don’t double up — ask your clinician what to do.

Preventing overdose means checking pill strength, using a pill box or app, and asking your pharmacist about interactions. Drugs that raise apixaban levels (like some antifungals or HIV meds) can increase bleeding risk. Always tell your provider about new prescriptions.

Need related reading? On RXConnected you can find practical guides on blood thinners, DVT support, and how to manage drug interactions — useful if you or a loved one takes anticoagulants.

Short version: serious bleeding needs urgent care. If you suspect an apixaban overdose, get medical help now and bring medication info with you. Quick action saves lives.