Last Updated: December 2024
Are you at risk for blood clots or stroke caused by atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE)? If so, your doctor might have prescribed you Eliquis. Eliquis is the brand name for the generic medication apixaban. It is a blood-thinning medication (formally known as an anticoagulant) that prevents the formation of blood clots.
Before taking Eliquis or any other medication that you’re prescribed, you should understand the side effects that you may experience. While many Eliquis side effects are mild, being aware of and monitoring more severe side effects is important and can help you determine when you should seek medical assistance. Some medications and food may also interact with Eliquis and increase your chances of serious side effects, so it’s important to know what you should avoid consuming while taking Eliquis. By learning about side effects and medication interactions, you’ll know when to report unusual symptoms to your healthcare provider.
Learning about the side effects of Eliquis can be challenging, as you may find yourself bombarded with technical jargon. Here’s a simple breakdown of the side effects to look out for when taking Eliquis.
What is Eliquis?
Eliquis is used to prevent and treat various medical conditions related to blood clotting. Medications that prevent blood clots are known as anticoagulants or blood thinners. Eliquis prevents blood clotting by binding to and inhibiting a key component in the blood clotting process called Factor Xa. It is preferred in some cases to older anticoagulants like Warfarin because it has a more predictable and consistent effect, which means that you will not require lab monitoring and will require fewer dose adjustments. However, like all blood thinners, a major side effect of Eliquis is an increased risk of bleeding, and you should only take it as prescribed by your doctor.
Eliquis is often prescribed to treat atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE). Atrial fibrillation is an irregular heart rhythm (arrhythmia) that causes blood clots in the heart’s upper chambers. Deep vein thrombosis is characterized by the formation of blood clots in veins that are located deep within the muscle. In contrast, pulmonary embolism occurs when the blood clot formed from DVT breaks free and travels through the body to the lungs. All three conditions can lead to potentially life-threatening conditions and require prompt medical attention.
What Are the Most Common Side Effects of Eliquis?
Like many medications, you may experience some minor side effects while taking Eliquis:
Minor bleeding
One of the most common side effects of Eliquis is an increase in minor and short-term bleeding. When taking Eliquis, you might notice nose bleeds, bleeding gums when you brush your teeth, heavier menstrual periods, and bleeding from cuts that take longer to stop than usual. Eliquis nosebleeds and similar side effects will last only a few minutes if they are minor. Be sure to monitor the frequency and duration of these side effects and contact a medical professional in the case of sustained and frequent bleeding events.
Easy bruising
Bruising is another common Eliquis side effect you might experience. Bruising occurs when the blood vessels near the surface of your skin break, and blood leaks out under the skin. This causes the bluish color that you see on the skin’s surface. With the ability of blood to clot reduced by Eliquis, blood may continue to leak for a longer period, causing larger bruises that form more easily.
Anemia, thrombocytopenia, and low blood pressure
Does Eliquis lower blood pressure? No, Eliquis does not affect blood pressure. However, increased bleeding caused by Eliquis could cause a decrease in your red blood cell count (anemia) or lower platelet count (thrombocytopenia), which can cause other side effects like fatigue, dizziness, and weakness.
Nausea
Nausea is a less common side effect of Eliquis that’s occasionally reported. You might experience nausea if you take Eliquis on an empty stomach. Sustained feelings of nausea should be reported to your healthcare provider, as they may indicate more severe side effects like internal bleeding.
What Are the Bad Side Effects of Eliquis?
Serious side effects of Eliquis are rare. However, you should still know about them if this medication is prescribed. When they do occur, severe Eliquis side effects require immediate medical attention. Be sure to monitor your Eliquis side effects and see a healthcare professional immediately if you experience the following:
Severe bleeding
Milder Eliquis side effects like nosebleeds and bleeding cuts are of concern if your bleeding becomes uncontrollable or frequent (for example, nose bleeds that don’t stop). You should seek medical attention if your bleeding becomes persistent or if you lose a lot of blood.
Internal bleeding
Can Eliquis cause blood in urine? Yes! Call your doctor or get medical help right away if you notice red, pink, or brown urine.
Another uncommon but severe side effect of Eliquis that you may experience is internal bleeding. This can occur in various body parts, including the gastrointestinal tract, the urinary tract, the kidneys, or even the brain! Internal bleeding can be tricky to detect since it’s not visible from outside of your body, but there are some indicators that you can look out for:
- Dark or bloody urine
- Blood in stool
- Bloody vomit or vomit that looks like coffee grounds
- Coughing up blood
- Severe headaches, dizziness, or fainting, which can indicate bleeding in the brain
Call your doctor or get medical help immediately if you notice red, pink, or brown urine.
Allergic reactions
A small percentage of people who take Eliquis are allergic to it. If you fall in this group, you may experience severe allergic reactions (anaphylaxis) to the medication. When taking Eliquis, look out for the formation of hives, chest pain, inflammation of the face, lips, throat, or tongue, or difficulty breathing or swallowing. These side effects indicate an allergic reaction to Eliquis and should be addressed immediately. You may also need to ask your healthcare provider to change your prescription.
Spinal bleeding
Spinal bleeding is an Eliquis side effect for which you should look out if you’ve had any spinal procedures recently. If you take Eliquis after having a spinal injection, epidural anesthesia, or spinal taps, you are at risk of developing spinal bleeding known as spinal subdural hematoma. It can compress the spinal cord and can result in paralysis. Early warning signs of a spinal blood clot that you can look out for include back pain or numbness and incontinence. You should avoid having spinal procedures while taking this medication and speak to your doctor before planning any.
Eliquis Dosage and Its Influence on Side Effects
The dosage of Eliquis prescribed to you can influence both its effectiveness and your risk of side effects. Your healthcare provider will prescribe an appropriate dosage based on factors like:
- The specific condition being treated (atrial fibrillation, deep vein thrombosis, or pulmonary embolism)
- Your age
- Your weight
- Any pre-existing conditions you may have
- Other medications you’re taking and potential interactions
Because the dosage prescribed to you is specific to your circumstances, it’s important to take Eliquis as directed by your healthcare provider. Taking less Eliquis than you’re prescribed (underdosing) or stopping Eliquis suddenly can reduce its effectiveness, leaving you vulnerable to blood clots and stroke.
Taking more medication than prescribed (overdosing) can be equally dangerous. Overdosing reduces the blood’s ability to clot, putting you in a dangerous situation where you can face extreme Eliquis side effects like internal bleeding.
The recommended dosage of Eliquis for most patients is 5 mg twice daily. However, the dosage may be reduced to 2.5 mg twice per day for persons who:
- Are 80 years old or above
- Weigh less than 132 pounds
- Have poor kidney function
- Are undergoing knee/hip replacement surgery
This lower dosage reduces the risk of Eliquis side effects in elderly patients, patients with low body weight, and other health conditions predisposed to severe side effects. If you’re planning an invasive surgery that risks substantial bleeding, your doctor might ask you to temporarily stop taking Eliquis.
Drug Interactions to Be Aware Of
When talking to your doctor about potentially starting treatment with Eliquis, you must inform them about any medications you’re currently taking. Interactions between Eliquis and other drugs or foods can interfere with its efficacy. Interactions can prevent Eliquis from working as intended, increasing your chances of suffering from blood clots. Drug interactions can also increase the absorption of either drug and cause dangerous side effects like internal bleeding.
Other blood thinners
When taking Eliquis, avoiding other blood-thinning (anticoagulant) medications is crucial. Taking Eliquis with other blood thinners can increase your chances of internal bleeding. Some to avoid are Xarelto (generic name rivaroxaban), Jantoven (warfarin), heparin, and Pradaxa (dabigatran).
Aspirin, Advil, and Aleve
If taken with Eliquis, Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can raise the risk of Eliquis side effects related to bleeding. NSAIDs treat pain, fever, and inflammation. They also affect the platelets in your blood, resulting in anti-clotting properties that can interact with Eliquis to increase bleeding. Unless your healthcare provider prescribes, you should avoid NSAIDs like Aspirin, Advil (ibuprofen) and Aleve (naproxen).
Antidepressants
Some classes of antidepressants can also interact with Eliquis to promote bleeding. These antidepressants prevent the platelets in your blood from clotting. Unless approved by your doctor, some antidepressants to avoid are Celexa (generic name citalopram), Prozac (fluoxetine), Zoloft (sertraline), Pristiq (desvenlafaxine), Cymbalta (duloxetine), and Effexor XR (venlafaxine).
Seizure medications
Some antiepileptic drugs like Tegretol (generic name carbamazepine) and Dilantin (phenytoin) can lower the effectiveness of Eliquis when taken together.
Stopping Eliquis Side Effects
To ensure safe treatment, you should take certain precautions to ensure proper usage of the medication and lower the risk of Eliquis side effects. Some precautions include:
Following dosage instructions
You should always take Eliquis in the exact dosage your doctor prescribes so that the medication works as intended. Taking a smaller dose or taking the drug less frequently than prescribed can prevent it from working effectively. Taking Eliquis more than prescribed can increase your risk of severe/internal bleeding.
Inform all of your healthcare providers that you’re taking Eliquis
Be sure to inform all your healthcare providers —including doctors, specialists, and even dentists! —that you’re taking Eliquis. This ensures they don’t prescribe or administer other medications that may interact with it. Healthcare providers may also instruct you to stop taking Eliquis before certain surgeries since it increases the risk of blood loss.
Inform your healthcare providers of other medications that you’re taking
Be sure to inform your doctor about any other medications you’re taking before you begin your Eliquis treatment. You should also inform your healthcare provider before starting any new medications, including over-the-counter drugs.
Blood tests
Your doctor may instruct you to take periodic blood tests to ensure that Eliquis is working as intended and to monitor the functioning of your kidneys and liver. Be sure to attend all blood test appointments to keep track of your health.
Monitor for signs of bleeding
As internal and external bleeding are the major side effects of Eliquis, you should watch out for any signs of abnormal bleeding. Monitor the duration and frequency of nosebleeds and make note of side effects that might indicate internal bleeding. Be sure to report concerning side effects to your doctor immediately.
Eliquis withdrawal symptoms
One of the crucial points to be aware of is the potential risk associated with abruptly discontinuing Eliquis. As the official Eliquis website mentions, stopping the medication without consulting the prescribing physician can significantly increase the risk of a stroke. This heightened risk is a reminder of the importance of adhering to medical advice and the potential consequences of withdrawal, emphasizing the gravity of maintaining consistent communication with healthcare professionals.
Eliquis Alternatives: Weighing the Options
There are numerous alternatives to Eliquis that you can take to treat blood clotting resulting from atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE). Many of these medications are in the same class as Eliquis, known as direct oral anticoagulants (DOACs). Some of these medications include:
- Edoxaban, which inhibits the same clotting component as Eliquis (Factor Xa)
- Xarelto, which also inhibits Factor Xa
- Pradaxa, which inhibits the blood clotting component thrombin
- Warfarin, an older blood thinner that is not a DOAC
Edoxaban, Xarelto, and Pradaxa all have side effects similar to Eliquis but are typically prescribed in different dosages. While Warfarin is the oldest anticoagulant medication on the market, it is well-established, has been used for many years, and has a reversal agent available for severe bleeding. Both Edoxaban and Warfarin require routine liver function tests throughout your treatment. Be sure to speak to your healthcare provider before switching to an Eliquis alternative.
If you are looking for alternatives to Eliquis, check out our post, where we compare Xarelto and Eliquis.
Managing Side Effects of Eliquis: Practical Tips
Eliquis side effects, while mild, can be bothersome in your day-to-day life. Thankfully, minimizing or stopping Eliquis’s side effects is possible using the following tips:
Get a full night’s sleep
To manage fatigue, you should always get a full night’s sleep so that you feel more energetic the next day.
Exercise
Regular physical activity can also help boost your energy levels and prevent fatigue.
Eat before taking your medication
Taking Eliquis on an empty stomach may contribute to feelings of nausea. Take Eliquis after a meal to help prevent this side effect.
Prevent injuries
To reduce the risk of bruising, be careful to avoid injuring yourself. Engage in physical activities carefully, and avoid wearing tight or irritating clothing.
You should consult your healthcare provider for appropriate medication for mild headaches or skin irritation, as some medications, like over-the-counter painkillers, may interact with Eliquis. For severe side effects like abnormal bleeding, you should immediately seek advice from your doctor. It’s important to avoid abruptly stopping Eliquis, as this may increase your risk of experiencing a blood clot or stroke.
Some Final Things to Consider
While Eliquis is effective in treating multiple conditions that cause blood clots and strokes, it’s important to understand the side effects you may experience while on this medication. Differentiating major conditions like abnormal bleeding from common side effects is important in determining whether you should see your healthcare provider and potentially receive an alternative prescription. Additionally, knowing about minor side effects can help you know what to expect and how to manage them while taking Eliquis.
Effective Management of Your Eliquis Costs
Understanding and managing Eliquis side effects is a cornerstone of maintaining your heart health. Similarly, being able to afford your medication without strain is integral to sustained wellbeing. The Rx Advocates can assist you in navigating patient assistance programs to make your Eliquis prescription more affordable month-to-month. By managing the economic aspect effectively, you can focus on dealing with any potential side effects without the worry of interruption due to costs. Discover how to make a beneficial impact on both your physical health and your budget — learn more about the savings opportunities available for Eliquis through The Rx Advocates here.
