How Do Eliquis and Alcohol Interact?

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS

 

Eliquis is a prescription medication that slows down blood clotting in the body. Many things can affect the speed of blood clotting processes. Eliquis is prescribed for patients at risk for blood clots and strokes.

Interactions with medications and other substances can impact Eliquis. Understanding how alcohol and other drugs interact with Eliquis is essential. Knowing what to watch for can help you best use this medicine.

What is Eliquis?

Eliquis is the brand name for the generic medication Apixaban. It is an anticoagulant used to control and decrease the clotting actions of blood. Eliquis comes in tablet form and is taken orally.

The benefit of this medicine includes:

  • Can decrease stroke risk
  • Can help patients with atrial fibrillation (which is a disorder of the rhythm of the heart) by decreasing clot risk
  • Can reduce the chance of blood clots forming
    • In patients with clotting disorders
    • In patients who have just had surgery (such as hip, knee, or joint replacement)

Eliquis is frequently used as a treatment option for existing clots. It is also a beneficial medication for preventing further clotting.

What are Blood Clots?

Blood clots most often develop in the large veins in the arms and legs. These clots are known as DVT or deep vein thrombosis. Left untreated, a DVT blood clot can break away and move through the veins.

When clots move through the body to the lungs, these are known as PE or pulmonary embolism. A PE is a serious situation requiring emergency medical attention. Without swift treatment, PE is often fatal.

Side Effects and Interactions

As with any medication, it’s critical to understand potential side effects and interactions. Knowing problems that may arise can help you get proper treatment.

Side Effects

Possible side effects include:

  • Symptoms of allergy to the medication (seek immediate emergency help):
    • Hives
    • Swollen extremities
    • Wheezy breathing
    • Pain in your chest
    • Dizziness or lightheadedness
    • Swollen tongue or lips
  • Spinal hematoma during spinal procedures (symptoms include legs weakening, tingling, or going numb)
  • Unusual bleeding
  • Excessive menstrual bleeding
  • Headache or migraine
  • Feeling dizzy or weak
  • Discoloration when urinating (colored red, brown, or pink)
  • Stools that are blood-filled or black-colored
  • Vomit that is bloody or has a coffee grounds look to it

Interactions

Certain things may interact with the results of Eliquis. They are:

  • St. John’s Wort – decreases the effectiveness
  • Grapefruit and grapefruit juice – could increase bleeding
  • Antibiotics – may decrease or increase the levels of Eliquis
  • Specific medical situations – such as bleeding ulcers, heart valve replacements, surgical procedures, and pregnancy
  • Allergic reaction – let your doctor know if you have any symptoms of allergy to Eliquis

How is Eliquis Affected by Drinking Alcohol?

Mixing alcohol and Eliquis may increase the risk of bleeding events, particularly gastrointestinal bleeds. Some indications are that 1-2 daily drinks have little to no effect on anticoagulants.

However, there are good reasons to avoid alcohol while on this medication. Always check with a medical professional with any questions or concerns.

Anticoagulation

Alcohol is known to act as a natural anticoagulant. Therefore, if you are taking Eliquis, limiting the amount of alcohol you consume is a good idea.

When blood clotting slows, it can be difficult to stop bleeding. If both alcohol and Eliquis are in the body, this can cause an emergency.

Stomach Bleeding

If you suffer from intestinal troubles, drinking alcohol while on Eliquis is not a safe plan.

Whether you have ulcers or another illness, you should use caution. The combination of alcohol and Eliquis can cause you to bleed internally. Bleeding ulcers are serious conditions requiring medical attention.

Absorption Rate

Some people have impaired rates of absorption of alcohol. This is particularly true among older adults.

Eliquis works most effectively when taken at consistent times. Drinking alcohol may impact the rate at which Eliquis absorbs into the body. Helping the body absorb at an even pace helps guard against blood clots.

Alcohol Use Disorder

Drinking alcohol can be considered a recreational aspect of life. For some people, though, drinking alcohol in any amount is an unhealthy decision.

When you have Alcohol Use Disorder, it can impact every area of your life. Whether mild, moderate, or severe, it is best to have a diagnosis followed by a treatment plan quickly.

Here are some of the signs and symptoms to watch for if alcohol use disorder is suspected:

  • Out of control alcohol consumption (no limits)
  • Trying (and failing) to cut back on how much you drink alcohol
  • Putting a lot of time and effort into getting, drinking, and then bouncing back from using alcohol
  • Uncontrollable urges and cravings for alcohol
  • Declining at work, in the classroom, or in your home life as a result of out-of-control drinking choices
  • Ignoring the problems (in social and work settings) alcohol creates and drinking anyway
  • Ignoring safety precautions (like drinking while driving) just to consume more alcohol
  • Tolerating higher and higher levels of alcohol without it impacting your abilities
  • Physical withdrawal between drinks (can include nausea, shaking, and sweating)

If you or someone you love experiences these or other troubling symptoms, seek help. Speaking with a medical professional is a good start. From there, you can receive the necessary resources to get treatment.

Treatment options often include:

  • Treatment centers (for help with detoxing and learning new coping skills)
    • Outpatient program (more short-term, individualized plan)
    • Inpatient program (more intensive, typically 30 days)
  • Attending 12-Step meetings (such as Alcoholics Anonymous)
  • Regular counseling or therapy sessions
  • Surrounding yourself with supportive people and situations

There are places to turn if you or someone you know needs help. There is a national helpline to reach someone 24 hours a day, seven days a week. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline can be reached at 1-800-662-HELP(4357).

What Medications Interact with Eliquis?

When taking Eliquis, it is important to take it as your doctor prescribes. Also, it’s necessary to disclose all medicines you are taking. This includes over-the-counter as well as prescriptions.

Some medications that may interact with Eliquis include:

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  24. Drugs.com. Tegretol. June 14, 2021. Available at: drugs.com.
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