No INR tests and few food restrictions — but a short action, so missed doses matter more than they did with warfarin.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Apixaban is a direct oral anticoagulant — a DOAC. It blocks factor Xa, one of the proteins in the clotting cascade, reducing the blood's ability to form clots.
It has largely replaced warfarin for most indications because it needs no routine INR blood tests, has far fewer food interactions, and works predictably at a fixed dose.
The trade-off is that it acts for a shorter time. Warfarin's effect persists for days, so a missed dose mattered little. Apixaban's effect fades within about 12 hours, so missing doses genuinely leaves you unprotected.
In atrial fibrillation, anticoagulation is the part of treatment that prevents strokes. Rate control makes you feel better; anticoagulation is what protects you.
Take it as soon as you remember on the same day, then continue as normal. Never double up.
Taking it twice daily reliably is the whole point. A pill organiser, a phone alarm, or pairing it with breakfast and an evening routine all help — and this is one medicine where adherence genuinely determines whether it works.
No INR testing is needed. But kidney function, full blood count and liver function should be checked at least annually, and more often where kidney function is borderline — because the dose depends on it.
Weight and age also affect dosing, so significant weight change is worth reporting.
Yes, to continue established treatment where the indication is documented, the dose is stable and recent kidney function is available.
We will not start anticoagulation remotely. Starting it requires a formal stroke risk assessment, a bleeding risk assessment, kidney function, weight, and a discussion of the trade-off between preventing strokes and causing bleeds. That is a face-to-face conversation.
Suspected DVT or pulmonary embolism is an emergency, not a prescription request. A swollen painful calf, or sudden breathlessness or chest pain, needs same-day assessment and scanning.
Apixaban is now available as a generic and has become considerably cheaper, though it still costs more than warfarin.
Against that, warfarin requires regular INR blood tests, so the total cost and inconvenience often favours apixaban.
Carry an anticoagulant alert card at all times. Available free from pharmacies, and genuinely important in an emergency.
Protection is lost within about 12 to 24 hours. In atrial fibrillation, stopping raises stroke risk immediately.
Pausing before surgery or dental work is planned in advance, based on the procedure's bleeding risk and your kidney function — typically 24 to 48 hours, and restarted promptly afterwards.
A specific reversal agent exists for apixaban, held in hospitals for serious bleeding. Worth knowing, as the lack of a reversal agent was a common early objection to DOACs.
Take it as soon as you remember that day, then carry on as normal. Never double up. Missing doses matters more than it did with warfarin, because the effect wears off within about half a day.
Not INR tests — but yes, kidney function at least annually. The dose depends on it, and kidney function changes with age and illness.
Moderate alcohol is generally acceptable. Heavy drinking increases bleeding risk and the risk of falls, which is the real hazard.
Get assessed today. This is the single most important safety point — bleeding inside the skull on an anticoagulant can be silent for hours and then sudden.
Avoid it. Paracetamol is the safer choice; topical gels are a reasonable alternative for joint pain.
No — that was warfarin. Apixaban has no vitamin K interaction, so eat normally.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
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It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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