Edoxaban is a type of medicine known as an anticoagulant.
It makes your blood flow through your veins more easily. This means your blood will be less likely to make a dangerous blood clot.
It's used to treat people who have had a health problem caused by a blood clot such as:
- a stroke
- a heart attack
- a blood clot in the leg (deep vein thrombosis, or DVT)
- a blood clot in the lungs (pulmonary embolism)
It's also used to prevent blood clots if you're at high risk of having them in the future. People who are at high risk include those who have an irregular heartbeat, known as atrial fibrillation.
Edoxaban is only available on prescription. It comes as tablets.
Who can take edoxaban
Most adults aged 18 and over can take edoxaban.
Edoxaban is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
- have ever had an allergic reaction to edoxaban or any other medicine
- are trying to get pregnant or you are already pregnant – edoxaban can be harmful to your baby
- have liver or kidney problems
- have had a recent spinal injury or spinal surgery
- have any injuries that are currently bleeding a lot, such as a wound
- have a stomach ulcer
- have antiphospholipid syndrome, a condition that affects the immune system and makes you more likely to get blood clots
- have ever had surgery to replace a heart valve
Dosage and strength
Edoxaban comes as 15mg, 30mg and 60mg tablets.
The usual dose of edoxaban is 60mg, taken once a day. Your doctor may prescribe a lower dose of 30mg a day if you:
- have kidney disease
- have a low body weight
- are taking ciclosporin
- are taking dronedarone (to treat atrial fibrillation)
- are taking erythromycin or ketoconazole
If you're unsure what dose you need to take, check with your pharmacist or doctor.
Swallow the tablet with a drink of water.
You can take edoxaban with or without food but try to take it at the same time every day.
How long to take it for
How long you need to take edoxaban will depend on why you're taking it.
If you've had a blood clot (deep vein thrombosis (DVT) or pulmonary embolism) you'll normally take edoxaban for at least 3 months. Depending on what caused the blood clot, you might need to take it for longer.
If you have atrial fibrillation you might need to take edoxaban long term or even for the rest of your life.
Do not stop taking edoxaban without talking to your doctor. If you stop taking it you may be at increased risk of serious health problems caused by blood clots.
If you forget to take it
If you forget a dose of edoxaban, take your tablet as soon as you remember. If you only remember the following day, leave out the forgotten dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember to take your medicines.
If you take too much
Taking too much edoxaban puts you at risk of bleeding.
- you take more than your prescribed dose of edoxaban
Your doctor or pharmacist will give you an anticoagulant alert card. Carry this with you all the time. It tells healthcare professionals that you're taking an anticoagulant. This can be useful for them to know in case of a medical emergency.
If you need any medical or dental treatment, show your anticoagulant alert card to the nurse, doctor or dentist. This includes before you have vaccinations and routine sessions with the dental hygienist.
Your doctor may advise you to stop taking edoxaban or reduce your dose for a short time.
Switching from warfarin to edoxaban
If you need to switch from warfarin to edoxaban, your doctor will advise you when to stop taking warfarin. This will probably be a few days before you start edoxaban.
Your doctor or anticoagulant clinic will do a blood test called the international normalised ratio (INR) to check how quickly your blood's clotting. This is to help decide exactly when you should start taking edoxaban.
Switching from edoxaban to warfarin
If you need to switch from edoxaban to warfarin, you may need to take both medicines together for a few days.
Your doctor or anticoagulant clinic will do a blood test called the international normalised ratio (INR) to check how quickly your blood's clotting. This is to help decide exactly when you should stop taking edoxaban.
Bleeding and what to do about it
While edoxaban has enormous benefits, the downside is that it can make you bleed more than normal. This is because while you're taking edoxaban your blood will not clot as easily.
It's usual to bleed more easily than normal while you're taking edoxaban. The kind of bleeding you might have includes:
- periods that are heavier and last longer than usual
- bleeding for a little longer than usual if you cut yourself
- occasional nosebleeds (that last for less than 10 minutes)
- bleeding from your gums when you brush your teeth
- bruises that come up more easily and take longer to fade than usual
This type of bleeding is not dangerous and should stop by itself. If it happens, keep taking the edoxaban, but tell your doctor if the bleeding bothers you or does not stop.
Things you can do to help yourself:
- Cuts – press on the cut for 10 minutes with a clean cloth.
- Nosebleeds – sit or stand upright (do not lie down), pinch your nose just above your nostrils for 10 to 15 minutes, lean forward and breathe through your mouth, and place an icepack (or a bag of frozen peas wrapped in a teatowel) at the top of your nose.
- Bleeding gums – try using a soft toothbrush and waxed dental floss to clean your teeth.
- Bruises – these are harmless but can be unsightly. It might help to make them fade more quickly if you put an ice pack wrapped in a towel over the bruise for 10 minutes at a time, several times a day.
What you can do to prevent bleeding
While you're taking edoxaban, be careful when you do activities that might cause an injury or a cut or bruising. It can help to:
- avoid playing contact sports or other activities that can cause an injury, such as football, rugby, hockey and horse riding
- wear gloves when you use sharp objects like scissors, knives and gardening tools
- stop wet shaving or removing hair with wax – use an electric razor or hair-removing cream instead
- take false teeth (dentures) or retainers out for a few hours a day, if you wear them, to give your gums a rest – do not wear dentures or retainers that do not fit properly
- tell your doctor, dentist or nurse that you take edoxaban before you have any medical or dental procedures or surgery – this includes vaccinations and routine appointments with the dental hygienist
Other common side effects
These common side effects of edoxaban happen to more than 1 in 100 people. They are usually mild and do not last long. There are things you can do to help cope with them:
Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.
Occasionally, you can have heavy bleeding from taking edoxaban. This can be dangerous and needs urgent medical attention.
- you have red pee or black poo
- you get bruises that happen for no reason, or bruises that are larger than you'd expect or that keep growing in size
- you get nosebleeds that you cannot stop and that last longer than 10 minutes
- you have blood in your vomit or you're coughing up blood
- you get severe headaches
- you have any bleeding from a cut or injury that will not stop or slow down
These are symptoms of serious bleeding. If you have any serious bleeding, stop taking edoxaban.
Very rarely, edoxaban can lead to bleeding in the brain.
you suddenly get any of these symptoms:
- a very severe headache
- seizures or fits
- sudden loss of vision or blurred vision
- numbness or tingling in your arms or legs
You may also feel tired, weak or sick.
In rare cases, edoxaban can cause a serious allergic reaction (anaphylaxis).
These are not all the side effects of edoxaban. For a full list see the leaflet inside your medicines packet.
Edoxaban and pregnancy
Edoxaban should not be taken during pregnancy.
If you take edoxaban and are planning to get pregnant or you become pregnant while taking it, speak to your doctor or specialist. You will need to be changed to a different medicine.
Edoxaban is not usually recommended while breastfeeding as there is not enough information to show that it's safe.
Speak to your doctor about other medicines you can use while breastfeeding.
Edoxaban and fertility
There's no evidence to suggest that taking edoxaban reduces fertility in either men or women.
Speak to a pharmacist or your doctor if you're trying to get pregnant.
Cautions with other medicines
Some medicines can affect how edoxaban works. This can lead to serious side effects.
Tell your doctor if you're taking any of these medicines before you start taking edoxaban:
- any other anticoagulant, such as warfarin or enoxaparin
- medicines to treat fungal or bacterial infections, such as fluconazole, erythromycin, clarithromycin or rifampicin
- medicines to treat an irregular heartbeat, such as dronedarone, quinidine or verapamil
- medicines to prevent organ rejection after a transplant, such as ciclosporin
- medicines to treat epilepsy, such as carbamazepine, phenytoin or phenobarbital
- non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin
You can take paracetamol while you're taking edoxaban.
Mixing edoxaban with herbal remedies and supplements
Do not take St John's wort, the herbal remedy for depression, while you're taking edoxaban. It can increase your risk of side effects.
There's not enough information to say that other herbal remedies and supplements are safe to take with edoxaban. They're not tested in the same way as pharmacy and prescription medicines.
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