Experiences with
Edoxaban

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.

Who may not be able to 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.

How to take it

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

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the edoxaban packet or leaflet inside it, any remaining medicine, and any other medicines you take.

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.

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.

Less serious bleeding

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:

These can be signs of anaemia. Speak to your doctor who may arrange a blood test.

If edoxaban makes you feel dizzy when you stand up, try getting up very slowly or stay sitting down until you feel better. If you begin to feel dizzy, lie down so that you do not faint, then sit until you feel better. Do not drive, cycle, or use tools or machinery while you're feeling dizzy.

If the dizziness does not go away or keeps happening, speak to your doctor. They may arrange a blood test to see if you have anaemia.

It may help to avoid rich or spicy food while you're taking edoxaban. If you're being sick, drink plenty of water by having small and frequent sips to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong smelling pee.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Try to rest and relax. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

If you need something to ease discomfort from indigestion, try taking an antacid. But do not put off seeing a pharmacist or doctor.

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.

Serious side effects

Serious bleeding

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.

Meds - serious side effects A&E safety messaging

In rare cases, edoxaban can cause a serious allergic reaction (anaphylaxis).

Meds New IA (H4) - serious allergic reaction

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 and breastfeeding

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.

Meds New IA (H2) - Pregnancy non-urgent care card

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

Taking edoxaban with everyday painkillers

You can take paracetamol while you're taking edoxaban.

Do not take aspirin or ibuprofen while you're taking edoxaban unless a doctor has said it's OK. They increase the chance of bleeding.

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.

Meds New IA (H2) - Cautions with other medicines alert