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See also Warning section.

Read the Medication Guide and, if available, the Instructions for Use provided by the pharmacist before your child starts apixaban and each time you get a refill. If you have any questions, ask the doctor or pharmacist.

This medication is taken by mouth with or without food as directed by the doctor, usually twice daily (every 12 hours). The dosage is based on your child's medical condition, weight, and response to treatment (see also Notes section).

Do not swallow the capsules whole. Open the capsule(s) and sprinkle the entire contents into a cup. Add 1 teaspoon (5 milliliters) of liquid. Use either water or infant formula. Do not use any other type of liquid. Stir until you can no longer see the medication in the liquid. Give the mixture right away using a syringe. To make sure you have given all of the medication, add another 1 teaspoon (5 milliliters) of liquid to the cup, stir, and give the rinse water using the same syringe. Throw away any unused liquid mixture after 2 hours. If your child has fluid restrictions, ask the doctor how much liquid should be used to mix the medication. Follow your doctor's instructions carefully.

If your child vomits or spits up within 30 minutes after taking a dose, give another dose at that time. If it is more than 30 minutes after taking a dose, do not give another dose. Give the next dose at the regular time.

Do not stop this medication without consulting the doctor. Some conditions may become worse when this drug is suddenly stopped. Do not run out of this medication. Order refills early to avoid running out of medication.

Use this medication regularly to get the most benefit from it. To help you remember, give it at the same times each day.

It is very important to give it exactly as directed. Do not increase the dose or give this drug more often or for longer than prescribed. Your child's condition will not improve any faster, and the risk of serious side effects will increase.

See also Warning section.

Nausea, vomiting, headache, easy bruising, or minor bleeding (such as nosebleed, bleeding from cuts) may occur. If any of these effects last or get worse, tell the doctor or pharmacist promptly.

Remember that this medication has been prescribed because the doctor has judged that the benefit to your child is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication can cause serious bleeding if it affects the blood clotting proteins too much. Tell the doctor right away if your child has any signs of serious bleeding, including: nosebleeds that happen often or don't stop, unusual tiredness/weakness, unusual pain/swelling/discomfort, unusual bruising, prolonged bleeding from cuts or gums, unusually heavy/prolonged menstrual flow, pink/dark urine, coughing up blood, vomit that is bloody or looks like coffee grounds, severe headache, dizziness/fainting, bloody/black/tarry stools, difficulty swallowing.

Get medical help right away if your child has any signs of very serious bleeding, including: vision changes, confusion, trouble speaking, weakness on one side of the body.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact the doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at MedWatch: The FDA Safety Information and Adverse Event Reporting Program.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before giving apixaban, tell the doctor or pharmacist if your child is allergic to it; or if your child has any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to the pharmacist for more details.

Before using this medication, tell the doctor or pharmacist your child's medical history, especially of: liver disease, kidney disease, bleeding problems (such as bleeding of the stomach/intestines, bleeding in the brain), blood disorders (such as anemia, hemophilia, thrombocytopenia), recent major injury/surgery, stroke, a certain clotting disorder (antiphospholipid syndrome), frequent falls/injuries.

Before your child has surgery or any medical/dental procedures (especially spinal puncture or spinal/epidural anesthesia), tell the doctor or dentist that your child is taking this medication and about all the products your child uses (including prescription drugs, nonprescription drugs, and herbal products). The doctor or dentist may tell you to stop giving apixaban before the surgery. Ask for specific instructions about stopping or starting this medication.

This medication may cause stomach bleeding. Daily use of alcohol while using this medicine may increase the risk for stomach bleeding. Avoid alcoholic beverages.

This medication can cause heavy bleeding. To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports. Your child should use an electric razor when shaving and a soft toothbrush when brushing their teeth. If your child falls or is injured, especially if your child hits their head, call the doctor right away. The doctor may need to check your child.

This form of apixaban is not usually used by adults. It is unlikely to be used during pregnancy or breastfeeding. Consult the doctor if you have any questions about this medication.

See also Warning section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are: mifepristone, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as warfarin/enoxaparin), certain antidepressants (including SSRIs such as fluoxetine, SNRIs such as desvenlafaxine/venlafaxine).

Other medications can affect the removal of apixaban from your child's body, which may affect how apixaban works. Examples include apalutamide, certain azole antifungals (such as itraconazole, ketoconazole, posaconazole), conivaptan, HIV protease inhibitors (such as lopinavir), rifamycins (such as rifabutin), ritonavir, St. John's wort, drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin), among others.

Aspirin can increase the risk of bleeding when used with this medication. However, if the doctor has told you to give aspirin, your child should keep taking the aspirin unless the doctor tells you not to. Ask the doctor or pharmacist for more details.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: bloody/black/tarry stools, pink/dark urine, unusual/prolonged bleeding.

Do not share this medication with others.

Lab and/or medical tests (such as hematocrit/hemoglobin, red blood cell count, weight monitoring) may be done while your child is taking this medication. Keep all medical and lab appointments. Tell the doctor about any weight changes. The doctor may need to adjust your child's dose. Consult the doctor for more details.

If your child misses a dose, give it as soon as you remember if it is on the same day. Give the next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Your child's condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).