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Apixaban Medical Vallei

About the medicine

How to use Apixaban Medical Vallei

Leaflet accompanying the packaging: information for the user

Apixaban Medical Valley, 2.5 mg, film-coated tablets

Apixaban

Read the leaflet carefully before taking the medicine, as it contains important information for the patient.

  • Keep this leaflet, you may need to read it again.
  • In case of any doubts, consult a doctor, pharmacist, or nurse.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
  • If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet

  • 1. What is Apixaban Medical Valley and what is it used for
  • 2. Important information before taking Apixaban Medical Valley
  • 3. How to take Apixaban Medical Valley
  • 4. Possible side effects
  • 5. How to store Apixaban Medical Valley
  • 6. Contents of the packaging and other information

1. What is Apixaban Medical Valley and what is it used for

Apixaban Medical Valley contains the active substance apixaban and belongs to a group of medicines called anticoagulants. This medicine helps prevent the formation of blood clots by blocking factor Xa, which is an important element in the blood clotting process.
Apixaban Medical Valley is used in adults:

  • to prevent the formation of blood clots (deep vein thrombosis) after hip or knee replacement surgery. After hip or knee surgery, the patient may be at increased risk of developing blood clots in the veins of the lower limbs. This can lead to swelling of the legs, which may be accompanied by pain or not. If a blood clot moves from the lower limb to the lungs, it can block blood flow through the lungs, causing shortness of breath with a feeling of chest pain or without. This condition (pulmonary embolism) can be life-threatening and requires immediate medical attention.
  • to prevent the formation of blood clots in the heart in patients with irregular heart rhythm (atrial fibrillation) and at least one additional risk factor. Blood clots can break loose and move to the brain, leading to a stroke, or to other organs, hindering blood flow to these organs (also known as systemic embolism). A stroke can be life-threatening and requires immediate medical attention.
  • to treat blood clots in the veins of the lower limbs (deep vein thrombosis) and in the blood vessels of the lungs (pulmonary embolism), as well as to prevent the recurrence of blood clots in the blood vessels of the lower limbs and/or lungs.

Apixaban Medical Valley is used in children from 28 days of age to less than 18 years of age to treat and prevent the recurrence of blood clots in the veins or in the blood vessels of the lungs.
The recommended dose depends on body weight, see section 3.

2. Important information before taking Apixaban Medical Valley

When not to take Apixaban Medical Valley

  • if the patient is allergicto apixaban or any of the other ingredients of this medicine (listed in section 6);
  • if the patient has excessive bleeding;
  • if the patient has organ diseasethat increases the risk of severe bleeding (such as active or recently diagnosed stomach or intestinal ulcers, recent bleeding in the brain);
  • if the patient has liver diseasethat leads to an increased risk of bleeding (liver coagulopathy);
  • if the patient is taking medicines that prevent blood clotting(e.g., warfarin, rivaroxaban, dabigatran, or heparin), except in situations where the anticoagulant treatment is changed, when the patient has a venous or arterial access catheter and heparin is administered through this catheter to maintain its patency or when the patient has a catheter inserted into a vein (is undergoing catheter ablation) due to irregular heart rhythm (arrhythmia).

Warnings and precautions

Before starting to take Apixaban Medical Valley, the patient should discuss with their doctor or pharmacist if they have any of the following conditions:

  • increased risk of bleeding, for example:
    • bleeding disorders, including conditions that result in decreased platelet activity;
    • very high blood pressure, uncontrolled with medication;
    • if the patient is over 75 years old;
    • if the patient's body weight is 60 kg or less;
  • severe kidney disease or if the patient is on dialysis;
  • liver disease or a history of liver disease
    • this medicine should be used with caution in patients with signs of liver function changes;
  • spinal or epidural catheter(anesthetic or pain-relieving), in which case the doctor will recommend taking this medicine after 5 or more hours after catheter removal;
  • if the patient has a prosthetic heart valve;
  • if the doctor considers that the patient's blood pressure is unstable or if other treatment or surgery is planned to remove a blood clot from the lungs.

When to be particularly careful when taking Apixaban Medical Valley

  • if the patient has a condition called antiphospholipid syndrome (an immune system disorder that increases the risk of blood clots), the patient should tell their doctor, who will decide whether to change the treatment.

In case of surgery or procedures that may cause bleeding, the doctor may ask the patient to temporarily stop taking this medicine for a short time.
If in doubt whether a given procedure may cause bleeding, the patient should ask their doctor.

Children and adolescents

This medicine is not recommended for use in children and adolescents with a body weight of less than 35 kg.

Apixaban Medical Valley and other medicines

The patient should tell their doctor, pharmacist, or nurse about all medicines they are taking, have recently taken, or plan to take.
Some medicines may enhance the effect of Apixaban Medical Valley, and some may weaken its effect. The doctor will decide whether the patient should be treated with Apixaban Medical Valley while taking other medicines and how closely they should be monitored.
The following medicines may enhance the effect of Apixaban Medical Valley and increase the risk of unwanted bleeding:

  • certain antifungal medicines(e.g., ketoconazole and others);
  • certain antiviral medicines used to treat HIV/AIDS(e.g., ritonavir);
  • other medicines used to reduce blood clotting(e.g., enoxaparin and others);
  • anti-inflammatoryor pain-relieving medicines(e.g., acetylsalicylic acid or naproxen). This is especially true for patients over 75 years old and taking acetylsalicylic acid, who may be at increased risk of unwanted bleeding;
  • medicines used to treat high blood pressure or heart problems(e.g., diltiazem);
  • antidepressant medicinescalled selective serotonin reuptake inhibitorsor serotonin and norepinephrine reuptake inhibitors.

The following medicines may reduce the ability of Apixaban Medical Valley to prevent blood clot formation:

  • medicines used to prevent seizures or fits(e.g., phenytoin and others);
  • St. John's Wort(a herbal supplement used in depression);
  • medicines used to treat tuberculosis or other infections(e.g., rifampicin).

Pregnancy and breastfeeding

If the patient is pregnant or breastfeeding, thinks they may be pregnant, or plans to have a child, they should consult their doctor, pharmacist, or nurse before taking this medicine.
The effect of Apixaban Medical Valley on pregnancy and the unborn child is unknown. This medicine should not be taken during pregnancy. If the patient becomes pregnant while taking this medicine, they should contact their doctor immediately.
It is not known whether Apixaban Medical Valley passes into breast milk. Before taking this medicine during breastfeeding, the patient should consult their doctor, pharmacist, or nurse. The patient may be advised to stop breastfeeding or stop/avoid taking this medicine.

Driving and using machines

It has not been found that Apixaban Medical Valley affects the ability to drive and use machines.

Apixaban Medical Valley contains lactose (a type of sugar) and sodium

If the patient has previously been diagnosed with intolerance to some sugars, they should contact their doctor before taking the medicine.
This medicine contains less than 1 mmol (23 mg) of sodium per tablet, which means the medicine is considered "sodium-free".

3. How to take Apixaban Medical Valley

This medicine should always be taken exactly as prescribed by the doctor or pharmacist. In case of doubts, the patient should consult their doctor, pharmacist, or nurse.

Dose

The tablet should be swallowed with water. Apixaban Medical Valley can be taken with or without food. To achieve the best treatment results, it is recommended to take the tablets at the same time every day.
If the patient has problems swallowing the tablets whole, they should talk to their doctor about other ways to take Apixaban Medical Valley. The tablet can be crushed and mixed with water or 5% glucose solution, juice, or apple puree immediately before administration.

Instructions for crushing tablets:

  • The tablet should be crushed with a pestle in a mortar.
  • Carefully transfer the entire powder to a suitable container and then mix it with a small amount of liquid (e.g., 30 mL or 2 tablespoons of water or another liquid mentioned above) to prepare a mixture.
  • The resulting mixture should be swallowed (drunk).
  • The pestle and mortar used to crush the tablets and the container should be rinsed with a small amount of water or another liquid (e.g., 30 mL) and then swallowed (drunk).

If necessary, the doctor may administer a crushed Apixaban Medical Valley tablet mixed with 60 mL of water or 5% glucose solution through a nasogastric tube.

Apixaban Medical Valley should be taken as recommended in the following indications:

Prevention of blood clot formation after hip or knee replacement surgery
The recommended dose is one Apixaban Medical Valley tablet of 2.5 mg twice a day. For example, one tablet in the morning and one in the evening.
The first tablet should be taken 12 to 24 hours after surgery.
If the patient has undergone major hip replacement surgery, they will usually take the tablets for 32 to 38 days.
If the patient has undergone major knee replacement surgery, they will usually take the tablets for 10 to 14 days.
Prevention of blood clot formation in the heart in patients with irregular heart rhythm and at least one additional risk factor
The recommended dose is one Apixaban Medical Valley tablet of 5 mgtwice a day.
The recommended dose is one Apixaban Medical Valley tablet of 2.5 mgtwice a day if:

  • the patient has severe kidney problems
  • two or more of the following conditions are met:
  • the patient's blood test results indicate decreased kidney function (serum creatinine level of 1.5 mg/dL (133 micromoles/L) or higher);
  • the patient is 80 years old or older;
  • the patient's body weight is 60 kg or less.

The recommended dose is one tablet twice a day, for example, one tablet in the morning and one in the evening. The doctor will decide how long to continue treatment.
Treatment of blood clots in the veins of the lower limbs and blood clots in the blood vessels of the lungs
The recommended dose is two tabletsof Apixaban Medical Valley of 5 mgtwice a day for the first 7 days, for example, two tablets in the morning and two in the evening.
After 7 days, the recommended dose is one tabletof Apixaban Medical Valley of 5 mgtwice a day, for example, one tablet in the morning and one in the evening.
Prevention of recurrence of blood clots after completing 6 months of treatment
The recommended dose is one Apixaban Medical Valley tablet of 2.5 mgtwice a day, for example, one tablet in the morning and one in the evening.
The doctor will decide how long to continue treatment.
Use in children and adolescents
Treatment and prevention of recurrence of blood clots in the veins or in the blood vessels of the lungs.
This medicine should always be taken or administered as recommended by the doctor or pharmacist. In case of doubts, the patient should consult their doctor, pharmacist, or nurse.
To achieve the best treatment results, the dose should be taken or administered at the same time every day.
The dose of Apixaban Medical Valley depends on body weight and will be calculated by the doctor.
The recommended dose for children and adolescents with a body weight of at least 35 kg is four tabletsof Apixaban Medical Valley of 2.5 mgadministered twice a day for the first 7 days, for example, four tablets in the morning and four in the evening.
After 7 days, the recommended dose is two tabletsof Apixaban Medical Valley of 2.5 mgadministered twice a day, for example, two tablets in the morning and two in the evening.
Recommendations for parents and caregivers: they should observe the child and ensure that they have taken the full dose.
It is essential to attend doctor's appointments as recommended, as the dose of the medicine may need to be adjusted if the patient's body weight changes.

The doctor may change the anticoagulant treatment as follows:

  • -Changing from Apixaban Medical Valley to anticoagulant medicinesThe patient should stop taking Apixaban Medical Valley. Treatment with anticoagulant medicines (e.g., heparin) should be started at the time of the scheduled intake of the next Apixaban Medical Valley tablet.
  • -Changing from anticoagulant medicines to Apixaban Medical ValleyThe patient should stop taking anticoagulant medicines. Treatment with Apixaban Medical Valley should be started at the time of the scheduled intake of the next dose of anticoagulant medicine, and then continue with the usual intake of Apixaban Medical Valley.
  • -Changing from treatment with a vitamin K antagonist (e.g., warfarin) to Apixaban Medical ValleyThe patient should stop taking the vitamin K antagonist. The doctor will order a blood test and inform the patient when to start taking Apixaban Medical Valley.
  • Changing from Apixaban Medical Valley to treatment with a vitamin K antagonist (e.g., warfarin)If the doctor informs the patient that they should start taking a vitamin K antagonist, they should continue taking Apixaban Medical Valley for at least 2 days after taking the first dose of the vitamin K antagonist. The doctor will order a blood test and inform the patient when to stop taking Apixaban Medical Valley.

Patients undergoing cardioversion

Patients with irregular heart rhythm who require cardioversion to restore a normal heart rhythm should take this medicine at the times specified by the doctor to prevent the formation of blood clots in the blood vessels of the brain and other blood vessels in the body.

Taking a higher dose of Apixaban Medical Valley than recommended

If the patient has taken a higher dose of this medicine than recommended, they should immediately inform their doctor.
The patient should take the packaging with them, even if there are no more tablets in it.
If the patient has taken a higher dose of Apixaban Medical Valley than recommended, they may be at increased risk of bleeding. If bleeding occurs, surgical treatment, blood transfusion, or other treatment that can reverse the effect of factor Xa inhibition may be necessary.

Missing a dose of Apixaban Medical Valley

  • If the patient forgets to take the morning dose, they should take it as soon as possible, and they can take the missed morning dose with the evening dose.
  • If the patient misses the evening dose, they can take it only on the same evening. They should not take a double dose the next morning, but instead, continue taking the medicine as recommended, twice a day.

In case of doubts about taking the medicine or if more than one doseis missed

The patient should consult their doctor, pharmacist, or nurse.

Stopping Apixaban Medical Valley

The patient should not stop taking this medicine without consulting their doctor, as the risk of blood clot formation may be higher if the medicine is stopped prematurely.
In case of any further doubts about taking this medicine, the patient should consult their doctor, pharmacist, or nurse.

4. Possible side effects

Like all medicines, Apixaban Medical Valley can cause side effects, although not everybody gets them.
Apixaban Medical Valley can be used in three different medical conditions. The known side effects and their frequency in each of these medical conditions may be different and are listed separately below. In these conditions, the most common overall side effect of this medicine is bleeding, which can potentially be life-threatening and may require immediate medical attention.
The following side effects may occur when taking Apixaban Medical Valley to prevent blood clot formation after hip or knee replacement surgery.

Common side effects (may occur in up to 1 in 10 people):

  • anemia, which can cause fatigue or pallor;
  • bleeding, including:
    • subcutaneous hemorrhages (bruises) and swelling;
  • nausea (vomiting).

Uncommon side effects (may occur in up to 1 in 100 people):

  • decreased platelet count (which can affect blood clotting);
  • bleeding:
    • after surgery, including subcutaneous hemorrhages and swelling, bleeding or other fluid leakage from the surgical wound/incision or injection site;
  • from the stomach, intestines, or rectum;
  • blood in the urine;
  • from the nose;
  • from the vagina;
    • low blood pressure, which can lead to fainting or rapid heartbeat;
    • blood test results may indicate:
  • liver function disorders;
  • increased activity of certain liver enzymes;
  • increased bilirubin levels, which can cause yellowing of the skin and eyes;
    • itching.

Rare side effects (may occur in up to 1 in 1000 people):

  • allergic reactions (hypersensitivity), which can cause facial swelling, lip, mouth, tongue, and/or throat swelling, and difficulty breathing. If any of these symptoms occur, the patient should immediately contact their doctor.
  • bleeding:
    • into the muscle;
    • into the eyes;
    • from the gums and presence of blood in sputum when coughing;
    • from the rectum;
  • hair loss.

Frequency not known (frequency cannot be estimated from the available data):

  • bleeding:
    • into the brain or spinal cord;
    • into the lungs or throat;
    • into the mouth;
    • into the abdominal cavity or into the space behind the abdominal cavity;
    • from hemorrhoids;
    • blood test results indicating blood in the stool or urine;
  • rash, which can form blisters and resembles small targets (dark spots in the center surrounded by a lighter border, with a dark ring around the edge) (erythema multiforme).
  • vasculitis (inflammation of blood vessels), which can cause skin rash or raised, flat, red, round spots under the skin surface or bruising.

The following side effects may occur when taking Apixaban Medical Valley to prevent blood clot formation in the heart in patients with irregular heart rhythm and at least one additional risk factor.

Common side effects (may occur in up to 1 in 10 people):

  • bleeding, including:
    • into the eyes;
    • from the stomach or intestines;
    • from the rectum;
    • blood in the urine;
    • from the nose;
    • from the gums;
    • subcutaneous hemorrhages (bruises) and swelling;
  • anemia, which can cause fatigue or pallor;
  • low blood pressure, which can lead to fainting or rapid heartbeat;
    • nausea (vomiting);
    • blood test results may indicate:
      • increased gamma-glutamyltransferase (GGT) activity.

Uncommon side effects (may occur in up to 1 in 100 people):

  • bleeding:
    • into the brain or spinal cord;
    • into the mouth or presence of blood in sputum when coughing;
    • into the abdominal cavity or from the vagina;
    • bright red blood in the stool;
    • after surgery, including subcutaneous hemorrhages and swelling, bleeding or other fluid leakage from the surgical wound/incision or injection site;
    • from hemorrhoids;
    • blood test results indicating blood in the stool or urine;
  • decreased platelet count (which can affect blood clotting);
  • blood test results may indicate:
    • abnormal liver function;
    • increased activity of certain liver enzymes;
    • increased bilirubin levels, which can cause yellowing of the skin and eyes;
  • rash;
  • itching;
  • hair loss;
  • allergic reactions (hypersensitivity), which can cause facial swelling, lip, mouth, tongue, and/or throat swelling, and difficulty breathing. If any of these symptoms occur, the patient should immediately contact their doctor.

Rare side effects (may occur in up to 1 in 1000 people):

  • bleeding:
    • into the lungs or throat;
    • into the space behind the abdominal cavity;
    • into the muscle.

Very rare side effects (may occur in up to 1 in 10,000 people):

  • rash, which can form blisters and resembles small targets (dark spots in the center surrounded by a lighter border, with a dark ring around the edge) (erythema multiforme).

Frequency not known (frequency cannot be estimated from the available data):

  • vasculitis (inflammation of blood vessels), which can cause skin rash or raised, flat, red, round spots under the skin surface or bruising.

The following side effects may occur when taking Apixaban Medical Valley to treat or prevent the recurrence of blood clots in the veins of the lower limbs and blood clots in the blood vessels of the lungs.

Common side effects (may occur in up to 1 in 10 people):

  • bleeding, including:
    • from the nose;
    • from the gums;
    • blood in the urine;
    • subcutaneous hemorrhages (bruises) and swelling;
  • into the stomach, intestines, or rectum;
  • into the mouth;
  • from the vagina;
    • anemia, which can cause fatigue or pallor;
    • decreased platelet count (which can affect blood clotting);
    • nausea (vomiting);
    • rash;
    • blood test results may indicate:
  • increased gamma-glutamyltransferase (GGT) or alanine aminotransferase (ALT) activity.

Uncommon side effects (may occur in up to 1 in 100 people):

  • low blood pressure, which can lead to fainting or rapid heartbeat;
  • bleeding:
    • into the eyes,
    • into the mouth or presence of blood in sputum when coughing;
    • bright red blood in the stool;
    • blood test results indicating blood in the stool or urine;
    • after surgery, including subcutaneous hemorrhages and swelling, bleeding or other fluid leakage from the surgical wound/incision or injection site;
    • from hemorrhoids;
    • into the muscle;
  • itching;
  • hair loss;
  • allergic reactions (hypersensitivity), which can cause facial swelling, lip, mouth, tongue, and/or throat swelling, and difficulty breathing. If any of these symptoms occur, the patient should immediately contact their doctor;
  • blood test results may indicate:
    • abnormal liver function;
    • increased activity of certain liver enzymes;
    • increased bilirubin levels, which can cause yellowing of the skin and eyes.

Rare side effects (may occur in up to 1 in 1000 people):

  • bleeding:
    • into the brain or spinal cord;
    • into the lungs;

Frequency not known (frequency cannot be estimated from the available data):

  • bleeding:
    • into the abdominal cavity or into the space behind the abdominal cavity;
    • rash, which can form blisters and resembles small targets (dark spots in the center surrounded by a lighter border, with a dark ring around the edge) (erythema multiforme);
    • vasculitis (inflammation of blood vessels), which can cause skin rash or raised, flat, red, round spots under the skin surface or bruising.

Additional side effects in children and adolescents
The patient should immediately inform their doctor if their child experiences any of the following symptoms:

  • Allergic reactions (hypersensitivity), which can cause: facial swelling, lip, mouth, tongue, and/or throat swelling, and difficulty breathing. These side effects are common (may occur in up to 1 in 10 people).

Generally, the side effects observed in children and adolescents treated with Apixaban Medical Valley were similar to those in adults, and their severity was mild or moderate. The side effects observed more frequently in children and adolescents were nosebleeds and abnormal vaginal bleeding.

Very common side effects (may occur in more than 1 in 10 people):

  • bleeding, including:
    • from the vagina;
    • from the nose.

Common side effects (may occur in up to 1 in 10 people):

  • bleeding, including:
    • from the gums;
    • blood in the urine;
    • subcutaneous hemorrhages (bruises) and swelling;
    • into the intestines or rectum;
    • bright red blood in the stool;
    • after surgery, including subcutaneous hemorrhages and swelling, bleeding or other fluid leakage from the surgical wound/incision or injection site;
  • hair loss;
  • anemia, which can cause fatigue or pallor;
  • decreased platelet count in the child's blood (which can affect blood clotting);
  • nausea (vomiting);
  • rash;
  • itching;
  • low blood pressure, which can lead to fainting or rapid heartbeat in the child;
  • blood test results may indicate:
    • liver function disorders;
    • increased activity of certain liver enzymes;
    • increased alanine aminotransferase (ALT) activity.

Frequency not known (frequency cannot be estimated from the available data):

  • bleeding:
    • into the abdominal cavity or into the space behind the abdominal cavity;
    • into the stomach;
    • into the eyes;
    • into the mouth or presence of blood in sputum when coughing;
    • from hemorrhoids;
    • into the brain or spinal cord;
    • into the lungs;
    • into the muscle;
  • rash, which can form blisters and resembles small targets (dark spots in the center surrounded by a lighter border, with a dark ring around the edge) (erythema multiforme);
  • vasculitis (inflammation of blood vessels), which can cause skin rash or raised, flat, red, round spots under the skin surface or bruising.
  • Blood test results may indicate:
    • increased gamma-glutamyltransferase (GGT) activity;
    • presence of blood in the stool or urine.

Reporting side effects

If side effects occur, including any side effects not listed in this leaflet, the patient should tell their doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Adverse Reaction Monitoring of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181 C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
Reporting side effects will help to gather more information on the safety of the medicine.

5. How to store Apixaban Medical Valley

The medicine should be stored out of sight and reach of children.
Do not use this medicine after the expiry date stated on the blister and carton after "EXP". The expiry date refers to the last day of the month stated.
There are no special storage instructions for this medicine.
Medicines should not be disposed of via wastewater or household waste. The patient should ask their pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the packaging and other information

What Apixaban Medical Valley contains

  • The active substance of the medicine is apixaban. Each tablet contains 2.5 mg of apixaban.
  • Other ingredients are: Tablet core: microcrystalline cellulose, anhydrous lactose(see section 2 "Apixaban Medical Valley contains lactose (a type of sugar) and sodium"), sodium lauryl sulfate, croscarmellose sodium, magnesium stearate; Tablet coating: hypromellose (E 464), lactose monohydrate(see section 2 "Apixaban Medical Valley contains lactose (a type of sugar) and sodium"), titanium dioxide (E 171), triacetin, yellow iron oxide (E 172).

What Apixaban Medical Valley looks like and contents of the pack

Yellow film-coated tablets in the shape of a lens, approximately 6 mm in diameter.
The tablets are packaged in PVC/PE/PVDC/Aluminum or PVC/PE/PVDC/Aluminum blisters or HDPE bottles in a cardboard box.
Package sizes:
Blisters: 10, 20, 21, 56, or 60 film-coated tablets;
HDPE bottle: 56, 60, 63, 70, 168, 200, 210, or 500 film-coated tablets;
Not all package sizes may be marketed.

Patient Alert Card: information for use

Inside the packaging of Apixaban Medical Valley, in addition to the patient information leaflet, there is a Patient Alert Card or the doctor will provide the patient with a similar card.
The Patient Alert Card contains information that is helpful to the patient and warns other doctors that the patient is taking Apixaban Medical Valley. The patient should always carry this card with them.

  • 1. The patient should take the card.
  • 2. If necessary, the patient should separate the card with the correct language (the perforated edges of the card will facilitate this).

3. The patient should fill in the following points or ask their doctor to fill them in:

  • First name and surname:
  • Date of birth:
  • Indication for use:
  • Dose: mg twice a day
  • Doctor's name:
  • Doctor's phone number:
  • 4. The patient should fold the card and always carry it with them.
  • Marketing authorization holder and manufacturer

    Marketing authorization holder

    Medical Valley Invest AB
    Brädgårdsvägen 28
    236 32 Höllviken
    Sweden
    email: safety@medicalvalley.se

    Manufacturer

    Laboratorios Liconsa S.A.
    Avenida De Miralcampo 7
    Poligono Industrial Miralcampo
    Azuqueca De Henares
    19200 Guadalajara
    Spain
    Zentiva S.A.
    Bulevardul Pallady Theodor Nr 50
    032266 Bucharest
    Romania

    This medicine is authorized in the Member States of the European Economic Area under the following names:

    Denmark
    Apixaban Medical Valley
    Netherlands
    Apixaban Xiromed 2.5 mg film-coated tablets
    Iceland
    Apixaban Medical Valley
    Germany
    Apixaban AXiromed 2.5 mg film-coated tablets
    Norway
    Apixaban Medical Valley
    Poland
    Apixaban Medical Valley
    Sweden
    Apixaban Medical Valley

    Date of last revision of the leaflet:

    • Country of registration
    • Active substance
    • Prescription required
      Yes
    • Importer
      Laboratorios Liconsa S.A. Zentiva S.A.

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    Yevgen Yakovenko

    General surgery11 years of experience

    Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

    Areas of medical expertise:

    • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
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    • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
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    • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
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    • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
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    • Member of the German Society of Surgeons (BDC).
    • Certified in radiological diagnostics and robotic surgery.
    • Active participant in international medical conferences and research.

    Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

    If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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    Doctor

    Jonathan Marshall Ben Ami

    Family medicine8 years of experience

    Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

    Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

    • Respiratory infections (cold, flu, bronchitis, pneumonia).
    • ENT conditions such as sinusitis, ear infections, and tonsillitis.
    • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
    • Urinary tract infections and other common infections.
    • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
    • Acute conditions requiring urgent medical attention.
    • Headaches, migraines, and minor injuries.
    • Wound care, health check-ups, and ongoing prescriptions.

    With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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    5.0(4)
    Doctor

    Salome Akhvlediani

    Pediatrics11 years of experience

    Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

    Her areas of focus include:

    • Fever, infections, cough, sore throat, and digestive issues.
    • Preventive care – vaccinations, regular check-ups, and health monitoring.
    • Allergies, asthma, and skin conditions.
    • Nutritional advice and healthy development support.
    • Sleep difficulties, fatigue, and behavioural concerns.
    • Ongoing care for chronic or complex health conditions.
    • Guidance for parents and follow-up after medical treatment.

    Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

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