Eliquis interactions: Alcohol, medications, and other factors

In some cases, a factor or condition could prevent your doctor from prescribing Eliquis due to the risk of harm. This is known as a contraindication. The contraindications of Eliquis include:

If you have active bleeding

Active bleeding refers to current bleeding, such as a bleeding ulcer. If you have active bleeding, doctors typically will not prescribe Eliquis. This is because the drug may cause serious bleeding, which could worsen any bleeding you already have. Your doctor can recommend other treatments that may be better for your condition.

If you have had an allergic reaction to Eliquis or any of its ingredients

If you have had an allergic reaction to Eliquis or any of its ingredients, your doctor will likely not prescribe Eliquis. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Eliquis, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe the drug.

There’s no known interaction between Eliquis and alcohol.

However, both alcohol and Eliquis can increase your risk of bleeding. (The two substances may prevent blood from clotting.) This means that drinking alcohol while taking Eliquis could increase your risk of bleeding further.

If you consume alcohol, talk with your doctor. They can advise you on whether there’s a safe amount to drink while taking Eliquis.

Before you start treatment with Eliquis, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Eliquis. Doctors may not prescribe Eliquis with these medications. Keep in mind that this chart does not include all drugs that may interact with Eliquis. Some of these interactions are described in detail just below in the “Drug interactions in depth” section.

* For more information about the side effects of Eliquis, see this article.
† To learn more, see “Certain antidepressant drugs” in the “Drug interactions in depth” section below.

Here’s a closer look at certain drug interactions of Eliquis.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a type of pain reliever. They’re often used to treat pain and inflammation.

Interaction result. Taking Eliquis with NSAIDs can increase the risk of bleeding.

Interaction explained. Eliquis works by blocking the action of a certain clotting factor called factor Xa. (A clotting factor is a substance that helps your blood clot.) By blocking the action, Eliquis makes your blood less likely to clot or helps prevent a blood clot you currently have from getting larger. This process can increase your risk of bleeding.

NSAIDs can prevent platelets (a type of red blood cell) from clumping together to form blood clots. By affecting the process that helps blood clots form, NSAIDs can also increase your risk of bleeding.

Taking Eliquis and NSAIDs together can further increase your risk of bleeding.

Examples of NSAIDs. Here are some NSAIDs that may interact with Eliquis:

• ibuprofen (Advil, Motrin)
• naproxen (Aleve, Naprosyn)
• diclofenac (Cambia, Cataflam, Zipsor, others)
• celecoxib (Celebrex)
• indomethacin (Indocin)

Steps you or your doctor may take. Several NSAIDs are available over the counter (OTC), meaning you can purchase them without a prescription. Before taking any OTC products with Eliquis, talk with your doctor or pharmacist. They’ll make sure these products do not contain NSAIDs that could interact with Eliquis.

If your doctor determines that it’s safe for you to take an NSAID with Eliquis, tell them right away if you have symptoms of bleeding. Examples include bloody stool or urine, coughing up blood, and unexplained bruising.

Thrombolytic drugs

Thrombolytic drugs are commonly called clot busters. They’re medications used to dissolve blood clots. Thrombolytics are typically used in emergency situations, such as dissolving a blood clot that’s affecting the brain or heart.

Interaction result. Taking Eliquis with a thrombolytic can increase the risk of bleeding.

Interaction explained. Eliquis works by blocking the action of a certain clotting factor called factor Xa. By blocking the action, Eliquis makes your blood less likely to clot or helps prevent a blood clot you currently have from getting larger. This process can increase your risk of bleeding.

Thrombolytic drugs are used to dissolve blood clots. By dissolving the clots, thrombolytics also increase your risk of bleeding.

When Eliquis and a thrombolytic are taken together, your risk of bleeding can increase.

Examples of thrombolytic drugs. Here are some thrombolytic drugs that may interact with Eliquis:

• alteplase (Activase)
• reteplase (Retavase)
• tenecteplase (TNKase)

Steps you or your doctor may take. Due to this risk, doctors typically will not prescribe thrombolytic drugs in combination with Eliquis. If you develop a blood clot while taking Eliquis, your doctor can advise you on the right treatment. They may increase your Eliquis dosage. (For details about Eliquis’ dosage, see this article.) Or they may switch you from Eliquis to a different drug, such as heparin.

Certain antidepressant drugs

Antidepressants are used to treat depression. Eliquis may interact with two classes of antidepressants:

• selective serotonin reuptake inhibitors (SSRIs)
• serotonin-norepinephrine reuptake inhibitors (SNRIs)

Interaction result. Taking Eliquis with an SSRI or SNRI can increase the risk of bleeding.

Interaction explained. Eliquis works by blocking the action of a certain clotting factor called factor Xa. By blocking the action, Eliquis makes your blood less likely to clot or helps prevent a blood clot you currently have from getting larger. This process can increase your risk of bleeding.

SSRIs and SNRIs affect chemicals in the body called serotonin and norepinephrine. These chemicals help platelets group together to form blood clots. By affecting serotonin and norepinephrine, SSRIs and SNRIs can prevent platelets from grouping together. This increases your risk of bleeding.

When Eliquis is taken with an SSRI or SNRI, your risk of bleeding can increase further.

Examples of antidepressant drugs. Here are some SSRIs that may interact with Eliquis:

• citalopram (Celexa)
• fluoxetine (Prozac)
• sertraline (Zoloft)

Here are some SNRIs that may interact with Eliquis:

• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)
• venlafaxine (Effexor XR)

Steps you or your doctor may take. Before taking Eliquis, be sure your doctor knows if you’re taking an antidepressant. They can advise you on whether it’s safe for you to take these medications together.

If your doctor does prescribe Eliquis with an antidepressant, watch for possible symptoms of bleeding. These can include unexplained bleeding, bloody urine or stool, and coughing up blood. If you develop symptoms, tell your doctor right away. They can instruct you on how to manage this side effect.

Eliquis may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Eliquis interactions with supplements

Before you start treatment with Eliquis, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Eliquis and herbs

Eliquis may interact with an herb called St. John’s wort. Taking Eliquis with this supplement could make Eliquis less effective than usual.

Eliquis and vitamins

There haven’t been any specific reports of vitamins interacting with Eliquis. However, it’s still important to talk with your doctor or pharmacist before taking any of these products during Eliquis treatment.

Eliquis interactions with food

It’s possible that grapefruit and grapefruit juice may interact with Eliquis. Taking the medication with grapefruit products may raise the level of Eliquis in your body. This may increase your risk of bleeding.

If you’d like to learn more about eating grapefruit or drinking grapefruit juice during treatment with Eliquis, talk with your doctor.

Eliquis and vaccines

No specific interactions between vaccines and Eliquis have been reported. If you have questions about getting vaccines during Eliquis treatment, talk with your doctor or pharmacist.

Eliquis and lab tests

Lab tests have not been reported to interact with Eliquis. If you’d like to learn more about getting certain lab tests while you take Eliquis, talk with your doctor or pharmacist.

Eliquis and cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Eliquis. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Eliquis. The impact of cannabis may affect how well you stick to your Eliquis treatment plan.

Note: Cannabis is illegal at a federal level, but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Eliquis. Before you take Eliquis, be sure to talk with your doctor about your health history. Eliquis may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Eliquis include:

• Heart valve. Your doctor is unlikely to prescribe Eliquis if you’ve had a heart valve replacement. The drug may not be safe to take in this case. If you’ve had a heart valve replacement, your doctor can recommend a different treatment.
• Active bleeding. If you have active bleeding, such as a bleeding ulcer, your doctor will not prescribe Eliquis. For details, see the “When to avoid Eliquis” section above.
• Liver problems. If you have severe liver problems, such as cirrhosis, your doctor may not prescribe Eliquis. It’s unknown whether the drug is safe for people with severe liver problems. Your doctor can suggest a different treatment option instead.
• Kidney problems. Your risk of side effects with Eliquis may increase if your kidneys do not work as well as they should. Before starting Eliquis treatment, make sure your doctor knows whether you have kidney problems. They may prescribe a lower dosage of Eliquis than usual.
• Planned surgery. Your risk of bleeding may increase with certain surgeries. Bleeding is also a common side effect of Eliquis. Having surgery while you’re taking Eliquis could further increase your risk of bleeding. For this reason, your doctor may have you stop taking Eliquis for a few days before a planned surgery. This should reduce your risk of bleeding with the surgery.
• Triple-positive antiphospholipid syndrome. Your doctor may not prescribe Eliquis if you have triple-positive antiphospholipid syndrome (APS). This condition causes blood clots. Eliquis can increase the risk of blood clots in people with APS. For this reason, if you have triple-positive APS, your doctor will likely recommend a treatment other than Eliquis.
• Pregnancy. It’s not known whether Eliquis is safe to take while pregnant. For details about taking Eliquis during pregnancy, see this article.
• Breastfeeding. It’s not known whether Eliquis passes into breast milk or if the drug causes side effects in a breastfed child. For more information about taking Eliquis while breastfeeding, see this article.
• Allergic reaction. If you’ve had an allergic reaction to Eliquis or any of its ingredients, your doctor will likely not prescribe Eliquis. You can ask them about other treatments that may be better choices for you.

Here are some frequently asked questions about Eliquis and possible interactions.

Does Eliquis interact with Tylenol?

There are not any known interactions between Eliquis and acetaminophen (Tylenol).

However, other over-the-counter (OTC) pain relievers are known to interact with Eliquis. This includes nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). Taking Eliquis with an NSAID can increase the risk of bleeding. For details, see the “Drug interactions in depth” section above.

Before taking any OTC drugs during your Eliquis treatment, talk with your doctor or pharmacist. They’ll make sure these medications are safe to take with Eliquis.

Is there an interaction between Eliquis and testosterone?

Eliquis and testosterone are not known to interact with each other.

However, there have been reports of an increased risk of blood clots with the use of testosterone products. Eliquis is used to help prevent or treat blood clots in certain situations. Therefore, it’s possible that taking Eliquis with testosterone could make Eliquis less effective than usual.

Before starting Eliquis treatment, be sure your doctor knows whether you’re using any testosterone products. They can advise you on whether Eliquis is a safe option for you.

Do Eliquis and Xanax interact with each other?

There’s no known interaction between Eliquis and alprazolam (Xanax).

Xanax is a drug that’s used to treat panic disorders and anxiety. Doctors may recommend benzodiazepines (such as Xanax) for people having hip or knee surgery. The medications may be prescribed along with Eliquis.

It’s important to talk with your doctor before taking Eliquis with Xanax. They can see whether these medications are right for you.

You can take certain steps to help prevent interactions with Eliquis. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

• Let them know if you drink alcohol or take cannabis.
• Tell them about any other medications and supplements you take.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Eliquis and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Eliquis by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Eliquis. These resources might help:

• Overview of Eliquis. For a general overview of Eliquis, you can see this article.
• Side effects. If you’re interested in the side effects of Eliquis, see this article. Another option is to refer to the Eliquis prescribing information.
• Dosage specifics. To learn about the dosage of Eliquis, see this article.
• Drug comparison. For information abouthow Eliquis compares with Xarelto, read this article.
• Cost information. To find out about the cost of Eliquis, see this article.
• Facts about blood clots. To learn more about blood clots, see our list of blood and hematology articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.