Can I Use OTC Pain Relievers While I Take Eliquis?

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

 

There are many times you will have to take a pain reliever while you take prescription medications. Eliquis is a vital prescription medication for many people.

When you take prescription medications like Eliquis, knowing how the medicine works is important.

You should know the side effects and medications that can interact with them. This includes over-the-counter medicines.

Understanding Drug Interactions

Medications are a tool used to better your health. There are medications for many medical conditions, including fighting illness and infections, reducing aches and pains, and helping control problems like diabetes or high cholesterol.

Medicines can come with other reactions: allergies, side effects, and drug interactions.

Drug interactions cause the medication to work differently in the body when it is taken with another substance.

This can be another drug, food or drink, alcohol, or supplements. It can also occur with certain medical conditions.

Examples of drug interactions can be:

  • Two different medications: Eliquis and aspirin
  • Medications and food: Statins and grapefruit
  • Medications and supplements: anticoagulant and ginkgo biloba
  • Medications and medical conditions: Peptic ulcers and aspirin

The result of interactions could be side effects, changing how the medicine(s) works and causing the drug to be less or more effective.

What is Eliquis?

Eliquis (apixaban) is an anticoagulant medication. Also called an anticoagulant, Eilquis is prescribed for a few different reasons.

  • Nonvalvular Atrial Fibrillation: It lowers the risk of stroke associated with nonvalvular AFib (irregular heartbeat)
  • Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE): It treats blood clots that have formed in the legs or lungs and lowers the risk of them forming again
  • Hip or knee replacement: It lowers the risk of a blood clot after these surgeries

One of the biggest side effects of Eliquis is bleeding. This medicine slows blood clotting so blockages can’t form. This also means external clotting takes longer, causing you to bleed more.

Over-the-Counter Pain Relievers

Over-the-counter (OTC) pain medicine is a type of medication you can buy without a prescription.

There are two categories of OTC pain relievers: acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs include aspirin, ibuprofen, and naproxen. The primary difference in these is what they are intended to treat.

MedicationRecommended DosageTreats

Important

Information

Acetaminophen

Brand names:

Tylenol

Feverall

Acephen

  • 650 mg-1000 mg 
  • Every 4-6 hours, as needed
  • General aches and pains
  • Headache
  • Fever
  • Can be found in combination drugs
  • Avoid if you have liver disease
  • Avoid if you drink alcohol often

Ibuprofen

Brand names:

Advil

Motrin IB

Iprin

Genpril 

  • 200 mg – 400 mg
  • Every 6 hours
  • General aches and pains
  • Headache
  • Pain associated with inflammation
  • GI bleeding can occur
  • Some side effects can be stomach upset, indigestion and nausea
  • Anyone with kidney disease should avoid

Naproxen

Brand names:

Aleve

Naprosyn

  • 220 mg
  • Every 8-12 hours
  • General aches and pains
  • Headache
  • Pain associated with inflammation
  • GI bleeding can occur
  • Some side effects can be stomach upset, indigestion and nausea
  • Anyone with kidney disease should avoid

Aspirin

Brand Names:

Bayer Aspirin

Buffering

Ecotrin

  • 325 mg – 650 mg
  • Every 4 hours
  • General aches and pains
  • Headache
  • Pain associated with inflammation
  • GI bleeding may occur, especially in the elderly, chronic smokers, drinkers, or people with a history of ulcers 
  • Should not be the first choice for pain reliever

How Does Eliquis Interact With OTC Pain Relievers?

This is something to consider with all prescription medications but especially with Eliquis. Knowing the interactions that can occur if you take these together is important.

Tylenol

Tylenol (acetaminophen) is a medicine that reduces fever and relieves pain. It is not an anticoagulant or an anti-inflammatory.

Tylenol is a safe alternative for pain relief if you take Eliquis. The exceptions to this are people who have a history of liver problems.

Please note that acetaminophen is not an NSAID, like other pain relievers. Only NSAIDs reduce and relieve inflammation in the body.

Ibuprofen and Naproxen

Two common NSAIDs are ibuprofen and naproxen. Unfortunately, if you take Eliquis, taking these can put you at a higher risk for bleeding.

Your chance of bleeding increases if you combine NSAID with Eliquis.

Though the bleeding incident can be minor, it can also be fatal. You should always consult your doctor for any medication and take the safest drug possible.

Aspirin

Aspirin is another type of NSAID. It reduces the blood’s ability to clump and form clots. Many people take low doses of aspirin regularly. Speak with your doctor before combining these medications.

What You Should Know

Taking Eliquis can be a bit tricky. There is a lot to think about.

Here are some key points about Eliquis and OTC pain relievers:

  • The safest pain reliever to take while on Eliquis (or any anticoagulant) is acetaminophen (Tylenol). Make sure you follow the recommended daily dosage guidelines.
  • Avoid oral NSAIDs. Your doctor may tell you to take an occasional dose but don’t do this without their knowledge.
  • Some topical pain relievers can help joint or muscle pain.

Your doctor or pharmacist can help you with complete information about Eliquis or any of these over-the-counter medications.

Save Money on Eliquis With The Rx Advocates

Eliquis is an expensive prescription drug. This medicine is not currently available in generic form, making it harder for some people to access it.

Insurance companies often don’t want to pay for it because there are cheaper alternatives – even if this is the BEST alternative.

Thankfully, The Rx Advocates can help.

At The Rx Advocates, we help people afford their prescription medications.

Our patient assistance programs help you find the best price for you. We take care of the whole process. You pay our service fee and the cost of the medication.

We help people save hundreds of dollars on their prescription medications every month. If you need help, we want to help you, too. Contact us today for more information.

  1. Medline Plus. Drug Reactions. February 7, 2022. Available at: medlineplus.gov.
  2. Eliquis. Tell Me How Eliquis Can Help. November 2022. Available at: eliquis.com.
  3. Michigan Health. Which Over-the-Counter Pain Medication Is Best? July 1, 2016. Available at: healthblog.uofmhealth.org.
  4. Medical News Today. Everything You Need to Know About NSAIDs. July 20, 2021. Available at: medicalnewstoday.com.
  5. Healthline. Is Tylenol (Acetaminophen) a Blood Thinner? February 21, 2019. Available at: healthline.com.
  6. Medical Xpress. Taking Blood Thinners with Certain Painkillers May Raise Bleeding Risk. April 15, 2014. Available at: medicalxpress.com.
  7. Cleveland Clinic. Should You Take Aspirin If You Are on Blood Thinners? January 21, 2021. Available at: health.clevelandclinic.org.
  8. North American Thrombosis Forum. Pain Relievers and Anticoagulation: What’s the Story? February 17, 2022. Available at: thrombosis.org.
  9. American Family Physician. Pain Relievers: Understanding Your Options. March 1, 2004. Available at: AAFP.org.
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