This article is for informational purposes only and does not constitute medical advice. Always consult your doctor or pharmacist before making any changes to your medication routine.
If you missed a dose of Eliquis (apixaban), take it as soon as possible on the same day. The Eliquis label says do not take 2 doses at the same time to make up for a missed dose. If you remember the next day, skip the missed dose and resume your normal schedule. If you are unsure, contact your pharmacist or doctor right away.
Why Missing Eliquis Is a Bigger Deal Than Missing Most Medications
Eliquis belongs to a class of drugs called anticoagulants, or blood thinners. Doctors prescribe it to reduce the risk of stroke in people with atrial fibrillation (AFib), and to treat or prevent blood clots like deep vein thrombosis (DVT) and pulmonary embolism (PE).
Blood thinners work by keeping your blood at a specific level of anticoagulation. When you miss a dose, that protection drops. The FDA-approved prescribing information for Eliquis includes a boxed warning that stopping the medication, even temporarily, increases the risk of blood clot formation.
A single missed dose won't automatically cause a stroke. But Eliquis isn't a medication where you can casually skip a day. The stakes are higher than with most prescriptions.
What to Do When You Miss an Eliquis Dose
Eliquis is taken twice daily. The FDA prescribing information states: if a dose is not taken at the scheduled time, take it as soon as possible on the same day, then resume the normal twice-daily regimen. It also says the dose "should not be doubled to make up for a missed dose." The patient Medication Guide puts it this way: "If you or your child misses a dose of ELIQUIS, take it as soon as you remember on the same day. Do not take 2 doses of ELIQUIS at the same time to make up for a missed dose. Return to your usual dosing schedule the next day."
- Take the missed dose as soon as you remember, if it is still the same day.
- If your next dose is coming up soon, the label still says to take the missed dose that same day, but never 2 doses at the same time. Ask your pharmacist how far apart to space them.
- If you remember the next day, do not take the missed dose. Resume your normal schedule.
- Never double up. Do not take two doses at once to compensate.
- Not sure? Call your pharmacist or doctor before taking anything.
What "same day" means in practice
The Eliquis label limits a missed dose to the same day. If you missed your morning dose and remember close to your evening dose time, it is still the same day, so the label says to take it as soon as you remember. It also says not to take 2 doses at the same time. If you are not sure how to space a late morning dose and your evening dose, call your pharmacist for guidance specific to your schedule.
Forgot to Take Eliquis? Scenarios by Time of Day
Say you normally take Eliquis at 8 AM and 8 PM. Here is how the label's same-day rule applies, depending on when you realize you missed your morning dose:
| When you remember | Hours until next dose (8 PM) | What to do |
|---|---|---|
| 9 AM | 11 hours | Take it now. Resume normal schedule. |
| 12 PM (noon) | 8 hours | Take it now. Resume normal schedule. |
| 2 PM | 6 hours | Take it now. Resume normal schedule. |
| 4 PM | 4 hours | Take it now, since it is still the same day. Ask your pharmacist how to space it from your 8 PM dose. |
| 7 PM | 1 hour | Still the same day, so the label says take it. Do not take it at the same time as your 8 PM dose. Call your pharmacist about spacing. |
If you missed your evening dose and it is now morning, it is a new day. Skip the missed dose and take your morning dose on time instead.
What NOT to Do After a Missed Dose
This part matters just as much as knowing the right steps.
| Do This | Not This |
|---|---|
| Take the missed dose as soon as possible on the same day | Wait until tomorrow and take a double dose |
| Call your doctor or pharmacist if you're unsure | Search forums for advice and self-adjust |
| Resume your normal schedule after the missed dose | Change your dosing times on your own |
| Set up a persistent reminder system | Rely on memory alone for a twice-daily med |
Never stop taking Eliquis without talking to your doctor first. The FDA label carries a boxed warning that discontinuing Eliquis increases the risk of stroke and blood clots.
Why Consistency Matters with Eliquis
Miss a vitamin? Not a crisis. Take your allergy pill a few hours late? You'll be fine.
Eliquis works differently. It has a half-life of about 12 hours, so it clears your body faster than older blood thinners like warfarin (which has a half-life of 20 to 60 hours). That shorter half-life is an advantage in some ways. You have fewer dietary restrictions and less lab monitoring. But it also means less buffer when you miss a dose. When the drug clears your system, your clotting activity returns toward normal, and the protection fades.
That's why Eliquis is prescribed twice daily: to keep a consistent level of anticoagulation around the clock. If you're managing multiple medications alongside Eliquis, the scheduling challenge only grows. Note that if you also take clopidogrel (Plavix), which is an antiplatelet drug rather than an anticoagulant like Eliquis, it has its own missed dose guidelines. See missed dose of clopidogrel.
How to Stop Missing Doses of Eliquis
The best approach to a missed dose of Eliquis is to prevent it from happening. A few strategies that work:
- Pair it with a daily habit. Take your morning dose with breakfast and your evening dose with dinner. Anchoring a medication to something you already do makes it harder to forget.
- Use a pill organizer. A weekly pill box lets you see at a glance whether you've taken today's dose. If you've had that "can't remember if I took it" moment, a pill organizer removes the guesswork.
- Set a persistent alarm. Regular phone alarms are easy to swipe away and forget. Pillo uses a persistent alarm that keeps going until you actually respond. For a twice-daily blood thinner, this level of accountability helps.
- Track your adherence. Seeing your own medication-taking history can motivate you to stay consistent. Pillo's adherence reporting shows you how many doses you've taken on time, so you can spot patterns before they become a problem.
For a medication where consistency directly affects your safety, "I forgot" isn't something you want happening regularly.
Frequently Asked Questions
What happens if I miss one dose of Eliquis?
A single missed dose of Eliquis temporarily reduces your protection against blood clots. Because Eliquis has a half-life of about 12 hours, the drug clears your system faster than older blood thinners. The FDA label says to take the missed dose as soon as possible on the same day. Do not take 2 doses at the same time. If you are concerned, contact your doctor or pharmacist.
Can I take Eliquis a few hours late?
Yes, as long as it is still the same day. The FDA label says to take the missed dose as soon as possible on the same day, and not to take 2 doses at the same time. If your next dose is coming up soon, ask your pharmacist how to space the two.
Is it dangerous to miss a dose of a blood thinner?
Missing a single dose of a blood thinner like Eliquis is usually not immediately dangerous, but it does reduce your protection. The risk varies depending on your individual situation (your condition, clot history, and other factors). The FDA prescribing information warns that discontinuing Eliquis increases the risk of thrombotic events (blood clots and stroke). Consistently missing doses is more concerning than a single missed dose. Talk to your doctor if it happens frequently.
What should I do if I missed two doses of Eliquis?
If you've missed two or more doses of Eliquis, contact your doctor or pharmacist before taking your next dose. Do not try to "catch up" by taking extra pills. Your doctor may want to evaluate your situation, especially if you have atrial fibrillation or a recent history of blood clots.
What happens if you only take Eliquis once a day instead of twice?
Taking Eliquis only once a day when it's prescribed twice daily leaves you without adequate anticoagulation for roughly half the day. Because the drug has a 12-hour half-life, your protection against blood clots drops significantly by the time the next dose is due. According to Cleveland Clinic, taking Eliquis only once a day may increase your risk of blood clots and stroke. Always follow your prescribed dosing schedule.
Can I take Eliquis with food?
Yes. Eliquis can be taken with or without food, according to the FDA label. Taking it with a meal can help build the habit into your daily routine: breakfast for your morning dose, dinner for your evening dose.
If remembering doses is the hard part, a medication reminder app that won't stop until you take your dose can take that job off your plate.
This article is for informational purposes only and is not a substitute for professional medical advice. Eliquis (apixaban) is a prescription medication. Always consult your doctor or pharmacist for advice specific to your medications, including what to do about a missed dose. If you experience unusual bleeding, bruising, or symptoms of a blood clot (sudden numbness, difficulty breathing, chest pain), seek emergency medical attention immediately.
Reviewed under our Medical Review Policy.
Sources
- FDA Prescribing Information (DailyMed). half-life of about 12 hours
- FDA Prescribing Information (DailyMed). 20 to 60 hours
- FDA. FDA-approved prescribing information for Eliquis
- Cleveland Clinic. Cleveland Clinic
- eliquis.bmscustomerconnect.com. twice daily
