Eliquis is a brand-name prescription drug. It’s FDA-approved to treat and prevent dangerous blood clots that can block blood vessels in your body.

Specifically, Eliquis is approved for use in adults to:

  • Prevent blood clots and stroke in people with nonvalvular atrial fibrillation (AFib). Nonvalvular AFib is a type of irregular heartbeat that’s not caused by a heart valve problem. With this condition, you have a raised risk for blood clots forming in your heart.
  • Treat deep vein thrombosis (DVT). A DVT is a blood clot that forms in a vein deep inside your body. DVTs most commonly occur in a vein in your leg, but they can also occur in your arm.
  • Treat pulmonary embolism (PE). A PE is a blood clot that blocks blood flow to your lungs. It usually occurs when a DVT gets dislodged and travels through your veins to your lungs.
  • Prevent DVT or PE from recurring. After you’ve had initial treatment for a DVT or PE, Eliquis helps prevent blood clots from occurring again.
  • Prevent DVT that could lead to PE in people who’ve had hip or knee replacement surgery. These surgeries raise your risk for getting these types of blood clots.

Eliquis comes as a tablet that you take by mouth. It’s available in two strengths: 2.5 milligrams (mg) and 5 mg. Eliquis contains the active drug apixaban.

Is Eliquis a blood thinner?

Yes, Eliquis is a blood thinner. It’s also called an anticoagulant. The process of your blood clotting is called coagulation. Anticoagulants such as Eliquis make your blood less able to form clots.

Effectiveness

For information on the effectiveness of Eliquis, see the “Eliquis uses” section below.

A generic version of Eliquis, called apixaban, has been approved. However, it may not be available yet. If you’re interested in using the generic version, ask your doctor if it’s an option for you.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Eliquis can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Eliquis. These lists don’t include all possible side effects.

For more information on the possible side effects of Eliquis, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Eliquis, you can do so through MedWatch.

Mild side effects

Mild side effects of Eliquis can include:*

  • bruising more easily than usual
  • nausea
  • anemia (low levels of red blood cells)

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Eliquis. To learn about other mild side effects, talk with your doctor or pharmacist, or view the Eliquis Medication Guide.

Serious side effects

Serious side effects from Eliquis can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects, which are explained below in “Side effect details,” include:

  • allergic reaction
  • bleeding
  • increased risk for blood clots if you stop Eliquis treatment early*
  • blood clots in your spine with spinal procedures*

* Eliquis has boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous. To learn more, see the “FDA warnings” section at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Eliquis. In clinical studies, allergic reactions occurred in less than 1% of people with AFib who took Eliquis to prevent blood clots. It’s not known how often allergic reactions occurred in people who took placebo (a treatment with no active drug) in clinical studies.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itching
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Eliquis. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Bleeding

Eliquis makes it for harder for your blood to form clots, which raises your risk for bleeding. While taking Eliquis, you may notice that you bruise or bleed more easily than usual. Also, it might take longer than usual for you to stop bleeding.

Minor bleeding that can occur with Eliquis includes bleeding gums, nosebleeds, rectal bleeding, and in women, periods that are heavier than usual.

However, bleeding can sometimes be more serious. It may even be life threatening in some cases. Keep in mind that bleeding can occur anywhere in your body.

For example, internal bleeding can happen in your stomach, intestines, abdomen (belly), lungs, kidneys, liver, brain, joints, or eyes. And bleeding from a damaged blood vessel can build up and clot in the surrounding tissues, causing a swelling called a hematoma.

How common is bleeding with Eliquis?

Bleeding is the most common side effect of Eliquis. In clinical studies, major bleeding occurred in:

  • 0.1% to 2.13% of people who took Eliquis for any condition
  • 0.5% of people who took a placebo (a treatment with no active drug) to treat or prevent DVT or PE

The rates of bleeding varied depending on the dosage and the condition being treated.

When to see your doctor about bleeding

While taking Eliquis, you should see your doctor if you have symptoms of potentially serious bleeding. These can include:

  • any bleeding that’s severe, lasts a long time, or won’t stop
  • frequent nosebleeds
  • unexpected vaginal bleeding
  • blood in your urine, which may be red, pink, or brown in color
  • blood in your stool, which may be red or black, or look like tar
  • vomiting blood or what looks like coffee grounds
  • coughing up blood
  • severe headache
  • dizziness, which could be a sign of low blood pressure caused by internal bleeding

If you have any symptoms of serious bleeding, call your doctor right away. If your symptoms feel life threatening, call 911 or your local emergency number.

You should also see your doctor if you fall and hit your head while taking Eliquis. A head injury could cause bleeding inside your skull.

Serious bleeding may sometimes need treatment with a blood transfusion. And if bleeding can’t be controlled or is life threatening, you may be given a drug to reverse the effect of Eliquis. To learn more, see the “Reversing Eliquis bleeds” section below.

Fatigue

Fatigue (lack of energy) wasn’t reported in clinical studies of Eliquis. However, fatigue can be a symptom of blood loss or anemia, which are possible side effects of Eliquis.

If you have fatigue while taking Eliquis, talk with your doctor. They may check you for any symptoms of internal bleeding. (See the “Bleeding” section above to learn more.) Your doctor may also test your blood to see if you’re anemic.

Water retention

Water retention wasn’t reported in clinical studies of Eliquis. However, water retention typically causes swelling that’s known as edema.

Edema can sometimes be a symptom of a blood clot, such as a deep vein thrombosis (DVT). Taking Eliquis reduces your risk for blood clots, but it’s still possible for them to form while you’re taking the drug.

A hematoma could also be mistaken for edema. Eliquis can sometimes cause a hematoma, which occurs when bleeding from a damaged blood vessel builds up and clots in the surrounding tissue. If this happens under the skin or in a muscle, it can cause a painful lump or swelling.

If you think you have water retention or edema while taking Eliquis, you should see your doctor. If the edema is caused by a blood clot or hematoma, it may need to be treated.

Increased risk for blood clots if you stop Eliquis treatment early

Eliquis helps prevent blood from clotting. Stopping Eliquis before you’re supposed to can increase your risk for developing a blood clot. And if you have a type of irregular heartbeat called atrial fibrillation (AFib), stopping Eliquis can increase your risk for having a stroke.

Eliquis has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Don’t stop taking Eliquis unless your doctor tells you to. If you need to stop taking Eliquis, your doctor may have you take a different drug to prevent blood clots.

You may need to stop taking Eliquis temporarily before certain surgical, medical, or dental procedures. In this case, your doctor will tell you when to stop Eliquis and when to start taking it again. And they may prescribe another drug to help prevent blood clots while you’re not taking Eliquis.

Blood clots in your spine with spinal procedures

If you have a spinal procedure while taking Eliquis, you may develop a blood clot in your spine. This type of blood clot is called a spinal or epidural hematoma. It can press on your spinal cord and cause paralysis that’s long lasting or even permanent.

Eliquis has a boxed warning for this side effect. This is the most serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Spinal procedures that can cause spinal or epidural hematoma include lumbar puncture (spinal tap) and spinal or epidural injections. A spinal tap is a procedure to test fluid from around your spinal cord. Spinal or epidural injections are used to give certain medications, such as anesthetics or pain relievers.

If you need a spinal procedure while you’re taking Eliquis, your doctor will monitor you for symptoms of blood clots. These include back pain, tingling, numbness, muscle weakness, and incontinence (loss of bladder or bowel control). Blood clots should be treated as soon as possible, so talk with your doctor right away if you experience these symptoms.

Your risk for blood clots is higher if:

  • you’ve had spinal surgery, problems with your spine, or difficult or repeated spinal procedures in the past
  • you have a catheter (thin tube) placed into your spine to deliver medication
  • you’re taking other drugs that affect blood clotting, including blood thinners such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen

The Eliquis dosage your doctor prescribes will depend on several factors. These include:

  • the reason you’re using Eliquis
  • other medications you may be taking

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths (2.5 mg and 5 mg)

Eliquis comes as a tablet that you take by mouth. It’s available in two strengths: 2.5 milligrams (mg) and 5 mg.

Dosage for treating DVT and PE

The usual dosage of Eliquis to treat deep vein thrombosis (DVT) or pulmonary embolism (PE) is as follows:

  • To start your treatment, you’ll take 10 mg twice a day for 7 days.
  • After that, you’ll take 5 mg once a day for as long as your doctor recommends (usually several months).

Dosage for preventing DVT and PE from recurring

Your doctor may prescribe Eliquis to help prevent DVT or PE from recurring (occurring again). Eliquis is prescribed for this use after you’ve taken an anticoagulant (blood thinner) to treat DVT or PE for at least 6 months.

The usual dosage of Eliquis to prevent DVT or PE from recurring is 2.5 mg taken twice a day. You’ll take this for as long as your doctor recommends.

Dosage for preventing DVT after a hip or knee replacement

After hip or knee replacement surgery, you have a higher risk for getting a DVT or PE. To prevent these blood clots, you’ll start taking Eliquis 12 to 24 hours after your surgery. Your healthcare provider will check to make sure the bleeding from your surgery has stopped before you take your first dose of the drug.

Your dosage of Eliquis will depend on whether you’ve had your hip or knee replaced. Typical dosages to prevent blood clots after these surgeries are as follows:

  • for a hip replacement, the usual dosage is 2.5 mg taken twice a day for 35 days
  • for a knee replacement, the usual dosage is 2.5 mg taken twice a day for 12 days

Dosage for preventing blood clots and stroke in people with AFib

The usual dosage of Eliquis for preventing blood clots and stroke in people with atrial fibrillation (AFib) is 5 mg taken twice a day.

However, your doctor may prescribe a dosage of 2.5 mg twice a day if two or more of these factors apply to you:

  • you’re age 80 years or older
  • you weigh 132 pounds (60 kilograms) or less
  • you have kidney problems

Dosage for older adults

A lower dosage of Eliquis is sometimes recommended for preventing blood clots and stroke in older adults with AFib. See the section directly above for more details.

However, the Eliquis dosage recommended for treating and preventing DVT and PE is the same for older and younger adults. See the sections above for details.

In clinical studies of Eliquis, there were no major differences in side effects between older and younger adults.

Dosage questions

Below are answers to some questions you may have about taking Eliquis.

What if I miss a dose?

If you miss a dose of Eliquis, take it as soon as possible. Then continue with your usual dosage schedule. You shouldn’t take two doses at once to make up for a missed dose.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

It depends why you’re taking it. For preventing blood clots and stroke in AFib, Eliquis is meant to be used as a long-term treatment. So if you and your doctor determine that Eliquis is safe and effective for you, you’ll likely take it long term.

However, to treat or prevent DVT or PE, you’ll typically take Eliquis for a few months. And to prevent DVT or PE after surgery, you’ll take it for a shorter time. You’ll take it for 12 days after a knee replacement and for 35 days after a hip replacement.

The Food and Drug Administration (FDA) approves prescription drugs such as Eliquis to treat certain conditions.

Eliquis is FDA-approved to treat and prevent certain types of dangerous blood clots that can block blood vessels in your body. It’s an anticoagulant drug (sometimes called a blood thinner). The process of your blood clotting is called coagulation. Anticoagulants such as Eliquis make your blood less able to form clots.

Specifically, Eliquis is approved for use in adults to:

These uses are explained in more detail below.

Eliquis for preventing blood clots and stroke in people with AFib

Eliquis is FDA-approved to reduce the risk of systemic embolism and stroke in people with AFib.

AFib is a type of irregular heartbeat. With this condition, you have an increased risk for blood clots forming in your heart. These clots can travel in your bloodstream and block blood vessels in other parts of your body, such as your kidneys or intestines. This is called a systemic embolism. If a clot blocks a blood vessel in your brain, this can cause a stroke.

Eliquis helps prevent blood clots, so it lowers your risk for a blood clot or stroke. It’s used when AFib is not caused by a heart valve problem.

Effectiveness for preventing blood clots and stroke in AFib

In two clinical studies, Eliquis was found to be effective for preventing blood clots and strokes. One study compared Eliquis with warfarin (Coumadin, Jantoven). The other compared Eliquis with aspirin in adults who couldn’t take warfarin.

Both warfarin and aspirin are common blood thinners that are recommended as treatment options for AFib in current guidelines from the American Heart Association.

In the warfarin study:

  • 1.27% of people who took Eliquis had a blood clot or stroke over 1 year of treatment
  • 1.6% of people who took warfarin had a blood clot or stroke over 1 year of treatment

In the aspirin study:

  • 1.62% of people who took Eliquis had a blood clot or stroke over 1 year of treatment
  • 3.63% of people who took aspirin had a blood clot or stroke over 1 year of treatment

Eliquis for treating DVT and PE

Eliquis is FDA-approved to treat deep vein thrombosis (DVT) and pulmonary embolism (PE).

A DVT is a blood clot that forms in a vein deep inside your body and blocks blood flow. DVTs most commonly occur in a vein in your leg, but they can also occur in your arm. A PE is a blood clot that blocks blood flow to your lungs. It usually occurs when a DVT gets dislodged and travels through your veins to your lungs.

Eliquis treats DVT and PE by stopping these types of blood clots from getting bigger. This allows your body to break down and clear the clot.

Effectiveness for treating DVT and PE

In a clinical study, Eliquis was found to be effective for treating DVT and PE. In this study, Eliquis was compared with enoxaparin (Lovenox) plus warfarin (Coumadin, Jantoven).

Enoxaparin and warfarin are effective anticoagulants that are commonly used to treat blood clots. Enoxaparin is given by injection, and warfarin is taken by mouth. Warfarin takes a few days to build up its effect, so enoxaparin is given along with warfarin for the first few days of treatment.

In this 6-month study:

  • 0.8% of people who took Eliquis had a DVT during treatment
  • 1.3% of people who took enoxaparin plus warfarin had a DVT during treatment
  • 0.4% of people who took Eliquis died from a blood clot during treatment
  • 0.6% of people who took enoxaparin plus warfarin died from a blood clot during treatment

View the drug’s prescribing information for more effectiveness information.

It’s important to note that your results from taking Eliquis may vary from those seen in clinical studies. If you have questions about whether Eliquis is right for you, talk with your doctor.

Eliquis for preventing DVT and PE from recurring

Eliquis is FDA-approved to help prevent DVT and PE from recurring (occurring again). The drug helps stop new blood clots from forming in your veins.

Eliquis is used for this purpose after you’ve already taken Eliquis or another anticoagulant drug for at least 6 months to treat DVT or PE.

Your doctor will prescribe Eliquis for this use if they think you have a high risk for getting another blood clot. Examples of factors that could raise your risk for a blood clot include:

  • broken bones
  • certain surgeries
  • not being able to move around much
  • taking certain birth control pills
  • pregnancy
  • heart or lung disease
  • cancer

Effectiveness for preventing DVT and PE recurrence

In a clinical study, Eliquis was found to be effective for preventing DVT and PE from recurring (occurring again). This study looked at adults who’d already taken an anticoagulant for 6 to 12 months to treat a DVT or PE. Everyone in the study took either Eliquis or placebo (a treatment with no active drug) for 12 months.

In this 12-month study:

  • 2.3% to 3.4% of people who took Eliquis had a DVT during treatment
  • 8.7% of people who took a placebo had a DVT during treatment
  • 2.6% to 3.5% of people who took Eliquis died from any cause during treatment
  • 4% of people who took a placebo died from any cause during treatment

View the drug’s prescribing information for more effectiveness information.

It’s important to note that your results from taking Eliquis may vary from those seen in clinical studies. If you have questions about whether Eliquis is right for you, talk with your doctor.

Eliquis for preventing DVT that could lead to PE after a hip or knee replacement

Eliquis is FDA-approved to prevent DVT that could lead to PE in people who’ve had hip or knee replacement surgery. These surgeries raise your risk for DVT. This is because the process of replacing your hip or knee can damage blood vessels around the joint, which can lead to DVT.

In addition, after the surgery you’ll be less mobile for a while. This means your blood will flow more slowly and could clot more easily. These issues can lead to a blood clot forming in a vein in your leg. If the clot dislodges, it can travel through your bloodstream to your lungs and lead to a PE.

Eliquis helps prevent blood clots, so it lowers your risk for having a DVT or PE after a hip or knee replacement.

Effectiveness for preventing DVT and PE after hip or knee replacement

Eliquis was found to be effective for preventing DVTs and PEs following hip or knee replacement surgeries in three clinical studies. In these studies, Eliquis was compared with enoxaparin (Lovenox). Enoxaparin is an effective, widely used anticoagulant that’s given by injection.

One study looked at people who took either 30 mg of Eliquis or enoxaparin for an average of 35 days following hip replacement surgery. A DVT or PE, or death from any cause, occurred in:

  • 1.39% of people who took Eliquis
  • 3.86% of people who took enoxaparin

Two studies looked at people who took Eliquis or enoxaparin (30 mg or 40 mg twice a day) for an average of 12 days following knee replacement surgery. PE occurred in:

  • 0.26% to 1% of people who took Eliquis
  • 0% to 0.44% of people who took enoxaparin

View the drug’s prescribing information for more effectiveness information.

Eliquis and children

Eliquis isn’t approved for use in children. It’s not known if this drug is safe or effective for treating or preventing blood clots in children. Research into the use of Eliquis in children is ongoing.

Eliquis makes your blood less able to clot, and the most common side effect of this is bleeding. Most bleeding that occurs with Eliquis is mild. For example, it might take longer than usual to stop bleeding if you cut yourself. Or you may bruise or bleed more easily than usual.

However, sometimes more serious, potentially life threatening bleeding can occur. See the “Eliquis side effects” section above for more information about bleeding with Eliquis.

Reversing bleeds with Andexxa

If you have severe, uncontrolled, or life threatening bleeding with Eliquis, this can be reversed with a drug called Andexxa. This drug is an antidote to Eliquis that’s used in an emergency. (An antidote is a drug that reverses the effect of another drug or substance.)

Andexxa is given in hospital by intravenous infusion (drip into a vein). The drug attaches to the Eliquis that’s in your body and stops it from working. This allows your blood to clot normally again.

Andexxa is also sometimes used if you need emergency surgery while taking Eliquis. Surgery carries a risk for bleeding, and this risk is higher if you’re taking Eliquis. To learn more, see the “Eliquis and surgery” section under “Eliquis interactions” below.

Eliquis can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Eliquis and other medications

Below are medications that can interact with Eliquis. This section doesn’t contain all drugs that may interact with Eliquis.

Before taking Eliquis, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

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

Eliquis and antiplatelets, including aspirin

Taking Eliquis with an antiplatelet drug can raise your risk for bleeding. You shouldn’t take Eliquis with an antiplatelet drug unless your doctor recommends it. Antiplatelets are drugs that help prevent blood clots. Eliquis also helps prevent blood clots, but it works differently than antiplatelets.

Eliquis works by attaching to an activated blood clotting factor, called factor Xa. (Clotting factors are proteins made by your liver.) Eliquis stops this clotting factor from working, which makes your blood less able to form clots. Antiplatelets, on the other hand, interfere with the binding of platelets. (This is the process that actually starts the formation of blood clots.)

Examples of antiplatelet drugs include:

If you’re taking an antiplatelet drug, ask your doctor if you should continue taking it when you start Eliquis. If your doctor recommends taking Eliquis with an antiplatelet, see them right away if you have any bleeding problems. To learn more, see the “Eliquis side effects” section above.

Eliquis and other anticoagulants

Eliquis is an anticoagulant drug (blood thinner) that helps prevent blood clots. Taking Eliquis with other anticoagulants can raise your risk for bleeding.

You shouldn’t take Eliquis with another anticoagulant drug unless you’re switching from one drug to the other. Examples of other anticoagulant drugs include:

  • rivaroxaban (Xarelto)
  • dabigatran (Pradaxa)
  • edoxaban (Savaysa)
  • fondaparinux (Arixtra)
  • dalteparin (Fragmin)
  • enoxaparin (Lovenox)
  • warfarin (Coumadin, Jantoven)
  • heparin

If you’re switching from another anticoagulant drug to Eliquis, talk with your doctor about how to do so safely.

Eliquis and ibuprofen or other nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are medications used to reduce swelling and pain. Ibuprofen also reduces fever. If taken with Eliquis, these drugs raise your risk for bleeding. You shouldn’t take ibuprofen or other NSAIDs while you’re taking Eliquis unless your doctor recommends it.

Examples of NSAIDs that shouldn’t be taken with Eliquis include:

  • ibuprofen (Ibu-Tab, Advil, Motrin)
  • diclofenac (Voltaren, Zipsor, Zorvolex, Arthrotec)
  • naproxen (Naprosyn, Anaprox DS, Naprelan, Aleve)
  • meloxicam (Mobic, Vivlodex)
  • celecoxib (Celebrex)

Certain over-the-counter cold and flu medications contain ibuprofen or naproxen. Ask your doctor or pharmacist about which cold and flu medications are safe for you to use while you’re taking Eliquis.

If you need to take a pain reliever or any other new medications during your Eliquis treatment, talk with your doctor or pharmacist.

Eliquis and Tylenol (not a known interaction)

Tylenol is a medication that relieves pain and reduces fever. It contains the active drug acetaminophen.

Unlike certain other pain relievers, Eliquis doesn’t interact with Tylenol. If you need a pain reliever or treatment for fever while you’re taking Eliquis, it’s safe to take Tylenol.

Eliquis and certain antidepressants

Taking Eliquis with certain antidepressants can raise your risk for bleeding. Examples of these antidepressants include:

If you need to take one of these antidepressants with Eliquis, talk with your doctor about whether it’s safe for you to use the drug with Eliquis. Your doctor may recommend a different type of antidepressant.

If you do take one of these antidepressants with Eliquis, call your doctor right away if you have any symptoms of serious bleeding. For information about possible symptoms of serious bleeding, see the “Eliquis side effects” section above.

Eliquis and certain antifungal drugs

Taking certain antifungals with Eliquis can increase the level of Eliquis in your body. Taking one of these drugs with Eliquis can raise your risk for bleeding.

Examples of antifungals that can increase Eliquis levels include:

  • itraconazole (Sporanox, Onmel, Tolsura)
  • ketoconazole

If you need to take one of these antifungal drugs with Eliquis, your doctor may prescribe a lower dosage of Eliquis. If this isn’t possible, your doctor can talk with you about other treatment options.

Eliquis and certain HIV drugs

Taking certain HIV drugs with Eliquis can increase the level of Eliquis in your body. Taking one of these drugs with Eliquis can raise your risk for bleeding.

Examples of HIV drugs that can increase Eliquis levels include:

  • cobicistat (Tybost)
  • ritonavir (Norvir)

If you need to take one of these HIV drugs with Eliquis, your doctor may prescribe a lower dosage of Eliquis. If this isn’t possible, your doctor can talk with you about other treatment options.

Eliquis and rifampin

Taking the antibiotic rifampin (Rifadin) with Eliquis can lower the level of Eliquis in your body. This could make Eliquis less effective in treating and preventing blood clots.

Rifampin should usually be avoided while you’re taking Eliquis. If you need to take this antibiotic, talk with your doctor about safe treatment options.

Eliquis and certain seizure medications

Taking Eliquis with certain drugs used to treat seizures can lower the level of Eliquis in your body. This could make Eliquis less effective in treating and preventing blood clots.

Examples of seizure drugs that can make Eliquis less effective include:

  • carbamazepine (Carbatrol, Equetro, Tegretol)
  • fosphenytoin (Cerebyx)
  • phenobarbital
  • phenytoin (Dilantin, Phenytek)
  • primidone (Mysoline)

These seizure drugs should usually be avoided with Eliquis. If you need to take a medication to treat seizures, talk with your doctor about safe treatment options.

Eliquis and herbs and supplements

Below is information about whether Eliquis interacts with certain herbs and supplements.

Eliquis and St John’s wort

Taking St John’s wort with Eliquis can lower the level of Eliquis in your body. This could make Eliquis less effective.

Because of this, you should avoid using St John’s wort while taking Eliquis.

Eliquis and turmeric

It’s not known if turmeric interacts with Eliquis.

Turmeric contains a compound called curcumin, which is known to have anti-inflammatory effects (it can reduce swelling). You shouldn’t use certain anti-inflammatory medications, such as ibuprofen, while taking Eliquis. (See “Eliquis and ibuprofen or other nonsteroidal anti-inflammatory drugs” above to learn more.)

Some research suggests that turmeric may affect the way that Eliquis is broken down in your body. This may lead to higher levels of Eliquis in your body, which could raise your risk for bleeding. However, it’s not known if turmeric affects the level of Eliquis enough to have a significant effect on your bleeding risk.

If you’re interested in using turmeric or curcumin while taking Eliquis, talk with your doctor first.

Eliquis and melatonin

Melatonin may reduce your body’s blood clotting ability. Because Eliquis also reduces blood clotting, it’s possible that taking Eliquis with melatonin could raise your risk for bleeding.

However, this interaction hasn’t been studied, and it’s not known for sure if it occurs. If you want to take melatonin with Eliquis, talk with your doctor first.

Eliquis and vitamin K (not a known interaction)

The way Eliquis works in your body isn’t affected by taking vitamin K.

A different anticoagulant called warfarin (Coumadin, Jantoven) is affected by vitamin K. Large amounts of vitamin K are found in certain foods, such as green leafy vegetables. People taking warfarin shouldn’t make big changes to their dietary intake of vitamin K. However, this isn’t the case with Eliquis.

If you have questions about your vitamin K intake while using Eliquis, talk with your doctor.

Eliquis and foods

Eliquis can interact with grapefruit. Therefore, you should avoid drinking grapefruit juice or eating grapefruit while taking Eliquis.

Eliquis is broken down by a protein in your liver called CYP3A4. Grapefruit and grapefruit juice block this protein from working as it normally does. If CYP3A4 can’t properly break down the drug, the amount of Eliquis in your body can get too high. This may raise your risk for serious side effects.

If you have questions about consuming grapefruit or grapefruit juice during your Eliquis treatment, talk with your doctor.

Eliquis and coffee (not a known interaction)

Drinking coffee or other drinks that contain caffeine doesn’t affect how Eliquis works in your body. In some cases, caffeine can affect a different anticoagulant called warfarin (Coumadin, Jantoven). However, this doesn’t happen with Eliquis.

There’s no need to avoid coffee or other drinks or food that contain caffeine while you’re taking Eliquis.

Eliquis and green leafy vegetables (not a known interaction)

Eating green leafy vegetables doesn’t affect how Eliquis works in your body. These vegetables contain high levels of vitamin K, which can affect a different anticoagulant called warfarin. (See the section above called “Eliquis and vitamin K” to learn more.) However, there is no reason to avoid eating green leafy vegetables while you’re taking Eliquis.

Eliquis and surgery

Surgery carries a risk of bleeding, and this risk is higher if you’re taking Eliquis. If you have a surgery planned, your doctor will typically recommend stopping Eliquis for a few days beforehand. This reduces your risk of bleeding with the surgery.

If you have a surgery planned, talk with your doctor about when you should stop taking Eliquis. You shouldn’t stop taking Eliquis unless your doctor tells you to.

Also talk with your doctor about when you should start taking Eliquis again after the surgery. You may be prescribed a different medication to prevent blood clots during the time you can’t take Eliquis.

If you need emergency surgery while you’re taking Eliquis, you may be given an antidote to Eliquis to reduce your risk for bleeding. (An antidote is a drug that reverses the effect of another drug or substance.) See the “Reversing Eliquis bleeds” section above for more information about this.

Alcohol isn’t known to interact with Eliquis. However, drinking excessive amounts of alcohol may not be safe while taking this medication.

Eliquis prevents your blood from clotting, and alcohol can also have this effect. Therefore, excessive alcohol use while you’re taking Eliquis could increase your risk for bleeding.

If you drink alcohol, talk with your doctor about how much is safe for you to drink while you’re taking Eliquis.

You may wonder how Eliquis compares with other medications that are prescribed for similar uses. Here we look at how Eliquis and Xarelto are alike and different.

Ingredients

Eliquis contains apixaban, and Xarelto contains rivaroxaban. Both drugs are anticoagulants, which are sometimes called blood thinners. Eliquis and Xarelto belong to the same class of drugs, direct-acting anticoagulants (DOACs). This means they work in the same way in your body to prevent blood clots from forming.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Eliquis and Xarelto to treat.

  • Both Eliquis and Xarelto are FDA-approved to:
    • prevent DVT or PE from recurring (occurring again)
    • prevent DVT that could lead to PE in people who’ve had hip or knee replacement surgery
  • Xarelto is also FDA-approved to:
    • prevent blood clots in people admitted to a hospital with an acute medical illness who are at risk of blood clots

Drug forms and administration

Eliquis and Xarelto both come as a tablet that you take by mouth. Eliquis is taken twice a day. Xarelto may be taken once or twice a day, depending on the condition you’re using it for.

Side effects and risks

Eliquis and Xarelto have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Eliquis, with Xarelto, or with both drugs (when taken individually).

  • Can occur with Eliquis:
    • nausea
    • anemia (low levels of red blood cells)
  • Can occur with Xarelto:
    • abdominal (belly) pain
    • back pain
    • muscle spasm
    • dizziness
    • itching
  • Can occur with both Eliquis and Xarelto:
    • bruising more easily than usual

Serious side effects

The following list contains examples of serious side effects that can occur with both Eliquis and Xarelto (when taken individually).

  • Can occur with both Eliquis and Xarelto:
    • bleeding
    • increased risk for blood clots if you stop treatment early*
    • blood clots in your spine with spinal procedures*

* Both Eliquis and Xarelto have boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Eliquis and Xarelto have different approved uses, but they’re both used to:

  • prevent blood clots and stroke in people with nonvalvular atrial fibrillation (AFib)
  • treat deep vein thrombosis (DVT) and pulmonary embolism (PE)
  • reduce your risk of getting another DVT or PE after initial treatment
  • prevent DVT and PE following hip or knee replacement surgery

Separate studies have found both Eliquis and Xarelto to be effective for all of these uses.

These drugs have been directly compared for preventing blood clots and stroke in people with AFib. Researchers found Eliquis and Xarelto to be similarly effective for this use.

A 2015 review of studies found Eliquis and Xarelto to be similarly effective for treating and preventing DVT and PE. However, a study from 2019 found Eliquis to be more effective than Xarelto at preventing DVT and PE from recurring (occurring again). Both studies also found Eliquis to have a lower risk of major bleeding than Xarelto.

Costs

According to estimates on GoodRx.com, Eliquis and Xarelto generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Eliquis and Xarelto are both brand-name drugs. A generic version of Eliquis, called apixaban, has been approved. However, it may not be available yet. If you’re interested in using the generic version, ask your doctor if it’s an option for you.

There are currently no generic versions of Xarelto. Brand-name medications usually cost more than generics.

Here are answers to some frequently asked questions about Eliquis.

What should I know about stopping Eliquis treatment?

If and when your doctor recommends that you stop taking Eliquis, you can do so without tapering off the drug. This means you don’t need to lower your Eliquis dosage gradually when stopping treatment. (Stopping a drug without tapering off is sometimes referred to as “stopping cold turkey.”)

However, stopping Eliquis before you’re supposed to can raise your risk for developing a blood clot. And if you have a type of irregular heartbeat called atrial fibrillation (AFib), stopping Eliquis can increase your risk for having a stroke. Eliquis has a boxed warning for this side effect. (To learn more, see the “FDA warnings” section at the beginning of this article.)

Don’t stop taking Eliquis unless your doctor tells you to. If you need to stop taking Eliquis, your doctor may have you take a different drug to prevent blood clots.

Your doctor will explain if and when you should stop taking Eliquis. How long you take Eliquis depends on the reason you’re taking it. For example, Eliquis only needs to be taken for 12 days after a knee replacement, because after this the risk of a blood clot is much lower.

However, when treating a DVT or PE, the length of treatment can vary depending on the likelihood that you’ll have another blood clot. And if you’re taking Eliquis to prevent blood clots and stroke because you have AFib, you’ll likely need to take it long term.

Taking Eliquis can raise your risk for bleeding with certain surgical, medical, or dental procedures. To reduce your risk for bleeding, your doctor may recommend stopping Eliquis for a few days beforehand. If you’re planning to have a procedure, ask your doctor if you’ll need to stop taking Eliquis. Your doctor may have you take a different drug to prevent blood clots while you’re not taking Eliquis. And they’ll also tell you when to start taking Eliquis again.

Can I take Eliquis once a day?

No, Eliquis needs to be taken twice a day. This helps keep a steady level of the drug in your blood.

Certain other blood thinners can be taken once a day. These include warfarin (Coumadin, Jantoven), rivaroxaban (Xarelto) and enoxaparin (Lovenox).

If you’re interested in a blood thinner that you take only once a day, talk with your doctor.

I accidentally took two Eliquis tablets in one dose. What should I do?

Accidentally taking two Eliquis tablets together is unlikely to cause any problems. If this happens, you should continue with your usual treatment schedule.

In clinical studies, no significant side effects were seen in healthy people who took much higher doses of Eliquis than this.

If you’ve taken too much Eliquis, talk with your doctor. They may recommend that you take activated charcoal. This should only be done under the supervision of your doctor.

If you have any side effects after taking an extra tablet, or if you take more than two tablets, call your doctor right away. Call 911 or your local emergency number if your symptoms feel life threatening.

Which cold medicines can you take with Eliquis?

While you’re taking Eliquis, it’s safe to take acetaminophen (Tylenol). This medication relieves pain such as headache, sore throat, and sinus pain. It also reduces fever. Acetaminophen doesn’t interact with Eliquis.

During your Eliquis treatment, it’s also safe to take decongestant medications such as pseudoephedrine (Sudafed). These drugs, which help relieve a blocked or stuffy nose, don’t interact with Eliquis. However, these medications aren’t right for everyone. For example, they’re not recommended for people with atrial fibrillation (AFib).

Medications that treat colds or the flu typically contain several ingredients. Some contain acetaminophen, but they may also contain other ingredients that you shouldn’t take with Eliquis. Examples of these ingredients include aspirin, ibuprofen, and naproxen. While using Eliquis, you shouldn’t take cold medicines that contain these ingredients. This is because they can increase your risk for bleeding.

If you want to take cold or flu medication with Eliquis, it’s best to talk with your doctor or pharmacist first. They can recommend a product that can help relieve your symptoms and is safe for you to take.

Are there any foods I should avoid while using Eliquis?

You should avoid drinking grapefruit juice or eating grapefruit while taking Eliquis. This is because Eliquis can interact with grapefruit.

Eliquis is broken down by a protein in your liver called CYP3A4. Grapefruit and grapefruit juice block this protein from working as it normally does. If CYP3A4 can’t properly break down the drug, the amount of Eliquis in your body can get too high. This may raise your risk for serious side effects.

If you have questions about consuming grapefruit or grapefruit juice during your Eliquis treatment, talk with your doctor.

To learn about consuming certain other foods and beverages with Eliquis, see the “Eliquis interactions” section above.

How does Eliquis affect INR?

Eliquis can increase your international normalized ratio (INR).

INR is used to describe the results of a lab test called prothrombin time (PT). PT monitors your blood’s ability to clot while you’re taking a different anticoagulant drug called warfarin (Coumadin, Jantoven). The dosage of warfarin is adjusted based on your INR.

However, unlike warfarin, your Eliquis dosage doesn’t need to be adjusted based on your INR. Therefore, you won’t have your INR checked while you’re taking Eliquis. However, if you’re switching between Eliquis and warfarin, your doctor may measure your INR before you make the switch.

If you’re switching from warfarin to Eliquis, your INR should be below 2.0. If you’re switching from Eliquis to warfarin, your doctor will determine the appropriate INR level for switching.

Does Eliquis affect blood pressure?

It’s unlikely. In clinical studies, low blood pressure occurred in some people who took Eliquis to prevent blood clots after hip or knee replacement. However, this wasn’t common.

If you’re concerned about your blood pressure while taking Eliquis, talk with your doctor.

Like Xarelto (above), the drug warfarin (Coumadin, Jantoven) has uses similar to those of Eliquis. Here’s a comparison of how Eliquis and warfarin are alike and different.

Ingredients

Eliquis contains the active drug apixaban. Warfarin is a generic drug that’s also available as the brand-name medications Coumadin and Jantoven. Both Eliquis and warfarin are anticoagulant drugs (sometimes called blood thinners). However, these drugs work differently in your body to prevent blood clots from forming.

Uses

Here is a list of conditions that the Food and Drug Administration (FDA) has approved Eliquis and warfarin to treat.

  • Eliquis and warfarin are both FDA-approved to:
    • prevent DVT or PE from recurring (occurring again) in adults
  • Eliquis is also FDA-approved to:
    • prevent DVT that could lead to PE in adults who’ve had hip or knee replacement surgery
  • Warfarin is also FDA-approved for use in adults to:
    • reduce the risk of further heart attacks, strokes, blood clots, and death in adults who’ve had a heart attack in the past

Drug forms and administration

Eliquis and warfarin both come as tablets that you take by mouth. Eliquis is taken twice a day. Warfarin is typically taken once a day, but your dosage may be adjusted based on the results of blood tests.

Side effects and risks

Eliquis and warfarin have some similar side effects and others that vary. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Eliquis, with warfarin, or with both drugs (when taken individually).

  • Can occur with Eliquis:
    • anemia (low levels of red blood cells)
  • Can occur with warfarin:
    • rash
    • hair loss
    • vomiting
    • diarrhea
  • Can occur with both Eliquis and warfarin:
    • nausea
    • bruising more easily than usual

Serious side effects

These lists contain examples of serious side effects that can occur with Eliquis, with warfarin, or with both drugs (when taken individually).

  • Can occur with Eliquis:
    • increased risk for blood clots if you stop treatment early*
    • blood clots in your spine with spinal procedures*
  • Can occur with warfarin:
    • purple toes syndrome (a condition in which your toes can turn purple and become painful)
    • kidney problems, such as kidney damage
  • Can occur with both Eliquis and warfarin:
    • bleeding†

* Eliquis has boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “FDA warnings” section at the beginning of this article.
Warfarin has a boxed warning for the risk for major or fatal bleeding.

Effectiveness

Eliquis and warfarin have different approved uses, but they’re both used to:

  • treat deep vein thrombosis (DVT) and pulmonary embolism (PE) in adults
  • prevent DVT or PE from recurring (occurring again) in adults
  • prevent blood clots and stroke in adults with atrial fibrillation (AFib)

One 6-month clinical study found Eliquis to be more effective than warfarin plus enoxaparin (Lovenox) for treating DVT and PE. (Enoxaparin is another anticoagulant drug that’s given by injection. Warfarin takes a few days to build up its effect, so enoxaparin is given along with warfarin for the first few days of treatment.)

In this study:

  • 2.3% of people who took Eliquis had another DVT or PE, or died from a blood clot
  • 2.7% of people who took warfarin plus enoxaparin had another DVT or PE, or died from a blood clot

Another clinical study found Eliquis to be more effective than warfarin for preventing blood clots and stroke in people with AFib. In this study:

  • 1.27% of people who took Eliquis had a stroke or blood clot
  • 1.6% of people who took warfarin had a stroke or blood clot

Both drugs were similarly effective at reducing the risk of stroke caused by a blood clot. However, people who took Eliquis were less likely to have a stroke caused by a bleed in the brain compared with people who took warfarin.

Eliquis is less likely to cause major bleeding than warfarin. Talk with your doctor if you have questions about which drug is right for you.

Costs

According to estimates on GoodRx.com, Eliquis is significantly more expensive than warfarin. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Eliquis is brand-name drug, while warfarin is a generic drug. Brand-name medications usually cost more than generics.

A generic version of Eliquis, called apixaban, has been approved. However, it may not be available yet. If you’re interested in using the generic version, ask your doctor if it’s an option for you.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Eliquis, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for treating DVT and PE

Examples of other drugs that may be used to treat deep vein thrombosis (DVT)* or pulmonary embolism (PE)† include:

* DVT is a blood clot that forms in a vein deep inside your body, usually in a leg.
† PE is a blood clot that blocks blood flow to your lungs.

Alternatives for preventing DVT and PE from recurring

Examples of other drugs that may be used to prevent deep vein thrombosis (DVT) or pulmonary embolism (PE) from recurring (occurring again) include:

  • dabigatran (Pradaxa)
  • rivaroxaban (Xarelto)
  • dalteparin (Fragmin)
  • warfarin (Coumadin, Jantoven)

Alternatives for preventing DVT after a hip or knee replacement

Examples of other drugs that may be used to prevent deep vein thrombosis (DVT) after a hip or knee replacement include:

  • dabigatran (Pradaxa)
  • rivaroxaban (Xarelto)
  • fondaparinux (Arixtra)
  • dalteparin (Fragmin)
  • enoxaparin (Lovenox)
  • warfarin (Coumadin, Jantoven)

Alternatives for preventing blood clots and stroke in people with AFib

Examples of other drugs that may be used to reduce the risk for blood clots and stroke in people with atrial fibrillation (AFib)* include:

  • aspirin
  • dabigatran (Pradaxa)
  • edoxaban (Savaysa)
  • rivaroxaban (Xarelto)
  • warfarin (Coumadin, Jantoven)

* AFib is a type of irregular heartbeat. With AFib, you have a higher risk for blood clots and stroke.

You should take Eliquis according to your doctor’s or healthcare provider’s instructions.

When to take

You should take Eliquis twice a day, in the morning and evening.

The best time to take Eliquis depends on your daily schedule, but ideally you should take it every 12 hours. For example, you could take a dose at 8 a.m. and 8 p.m. each day. Pick dosage times that fit with your daily routine to help you remember to take your dose.

To help make sure you don’t miss a dose, you can also use a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A kitchen timer can work, too.

Taking Eliquis with food

You can take Eliquis either with or without food.

Can Eliquis be crushed, cut, or chewed?

If you have trouble swallowing Eliquis tablets whole, they can be crushed. However, Eliquis tablets shouldn’t be cut in half or chewed.

Crushed tablets can be mixed with water, apple juice, apple sauce, or 5% dextrose in water (a type of sugar solution). The mixture should be taken by mouth right after mixing.

For people who can’t take medication by mouth, Eliquis can also be taken through a nasogastric tube (a thin tube that goes through your nose to your stomach). When taken this way, Eliquis should be crushed and mixed with 2 ounces (60 milliliters) of water or 5% dextrose in water.

If you have trouble swallowing Eliquis tablets whole, talk with your doctor or pharmacist about the best way to take the drug.

Eliquis is used to treat and prevent dangerous blood clots that can block blood vessels in your body.

What causes blood clots?

Blood clots can form inside your blood vessels if your blood is prevented from flowing freely around your body. There are many reasons why this can happen.

Examples of factors that could raise your risk for a blood clot include:

  • broken bones
  • certain surgeries
  • not being unable to move around much
  • taking certain birth control pills
  • pregnancy
  • heart or lung disease
  • cancer

When your blood doesn’t flow freely, blood cells called platelets start clumping together inside your blood vessels. The platelets make substances that activate clotting factors in your blood. (Clotting factors are proteins made by your liver.) When activated, clotting factors cause blood clots to form.

A blood clot that develops in a vein deep inside your body (typically your leg) is called a deep vein thrombosis (DVT). Sometimes a DVT can become dislodged and travel through your bloodstream to your lungs. This is called a pulmonary embolism (PE). A blood clot that develops in your heart can travel through your bloodstream to your brain and cause a stroke.

What Eliquis does

Eliquis is a type of drug called a direct-acting anticoagulant (DOAC). It’s sometimes also called a blood thinner, although it doesn’t actually thin your blood. Instead, Eliquis works by attaching to an activated blood clotting factor, called factor Xa. Eliquis stops this clotting factor from working, which makes your blood less able to form clots.

When you take Eliquis to treat a DVT or PE that you already have, the drug stops these clots from getting bigger. This allows your body to dissolve the clots naturally.

How long does it take to work?

Eliquis starts working within 3 to 4 hours after you take your first dose. However, you need to take it twice every day to make sure there’s always enough medication in your body to help stop blood clots from forming.

How long does Eliquis stay in your system?

Eliquis stays in your system for about 2 to 3 days after you stop taking it. For this reason, you should stop taking Eliquis at least 48 hours before a major surgery with a high risk for bleeding. For a surgery with a low risk for bleeding, you’ll need to stop taking the drug at least 24 hours beforehand.

Talk with your doctor about pausing your Eliquis treatment if you have a surgery scheduled.

Using more than the recommended dosage of Eliquis increases the risk of serious, life threatening bleeding.

Do not use more Eliquis than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

  • bleeding that’s severe or won’t stop
  • blood in your urine, which can make your urine red, pink, or brown
  • blood in your stool, which may be red or black, or look like tar
  • vomiting blood or vomit that looks like coffee grounds
  • coughing up blood
  • severe headache
  • dizziness, which could be a sign of low blood pressure due to internal bleeding

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. They may recommend that you take activated charcoal. This should only be done under the supervision of your doctor.

You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool if you’ve taken too much Eliquis. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

As with all medications, the cost of Eliquis can vary. To find current prices for Eliquis in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Eliquis, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Eliquis, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Eliquis, or if you need help understanding your insurance coverage, help is available.

Bristol-Myers Squibb Company, the manufacturer of Eliquis, offers a program called Eliquis 360 Support. For more information and to find out if you’re eligible for support, call 855-ELIQUIS (855-354-7847) or visit the program website for your particular condition: atrial fibrillation or deep vein thrombosis (DVT)/pulmonary embolism (PE).

Generic version

A generic version of Eliquis, called apixaban, has been approved. However, it may not be available yet. If you’re interested in using the generic version, ask your doctor if it’s an option for you.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

It’s not known if Eliquis is safe to take during pregnancy. This medication hasn’t been studied in pregnant women, and it’s not known if it can cause birth defects or miscarriage.

Taking anticoagulants like Eliquis during pregnancy can raise the risk of bleeding for you and the fetus. And if you take Eliquis and have an epidural for pain relief during labor, this may raise your risk for blood clots in the spine. In fact, Eliquis has a boxed warning for the risk of developing a blood clot in your spine with spinal procedures. To learn more, see the “FDA warnings” section at the beginning of this article.

Some women need to take anticoagulants during pregnancy because they have a high risk for blood clots. However, anticoagulants other than Eliquis are usually preferred. This is because more is known about the safety of using certain other anticoagulants during pregnancy than what’s known about Eliquis.

If you’re pregnant or planning a pregnancy, talk with your doctor about whether Eliquis is right for you. If you become pregnant while taking Eliquis, see your doctor right away.

It’s not known if Eliquis is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Eliquis.

For more information about taking Eliquis during pregnancy, see the “Eliquis and pregnancy” section above.

It’s not known if Eliquis is safe to take while breastfeeding or if it passes into breast milk. It’s also not known if the drug can affect your body’s production of breast milk. Therefore, it’s not recommended that you take Eliquis while breastfeeding.

If you’re currently breastfeeding or plan to breastfeed, talk with your doctor about your treatment options and the best way to feed your child.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Increased risk for blood clots if you stop Eliquis treatment early

Stopping Eliquis before you’re supposed to can raise your risk for developing a blood clot. And if you have a type of irregular heartbeat called atrial fibrillation (AFib), stopping Eliquis can increase your risk for having a stroke. Don’t stop taking Eliquis unless your doctor tells you to. If you need to stop taking Eliquis, your doctor may have you take a different drug to prevent blood clots.

Blood clots in your spine with spinal procedures

If you have a spinal procedure while taking Eliquis, you may develop a blood clot in your spine. This type of blood clot is called a spinal or epidural hematoma. It can press on your spinal cord and cause paralysis that’s long lasting or even permanent.

Spinal procedures that can cause spinal or epidural hematoma include lumbar puncture (spinal tap) and spinal or epidural injections. A spinal tap is a procedure to test fluid from around your spinal cord. Spinal or epidural injections are used to give certain medications, such as anesthetics or pain relievers.

If you need a spinal procedure while you’re taking Eliquis, your doctor will monitor you for symptoms of blood clots. These include back pain, tingling, numbness, muscle weakness, and incontinence (loss of bladder or bowel control). Blood clots should be treated as soon as possible, so talk with your doctor right away if you experience these symptoms.

Your risk for blood clots is higher if you’ve had spinal surgery, problems with your spine, or difficult or repeated spinal procedures in the past. Your risk is also higher if you have a catheter (thin tube) placed into your spine to deliver medication. In addition, your risk is higher if you’re taking other drugs that affect blood clotting. These include blood thinners such as aspirin, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

Other precautions

Before taking Eliquis, talk with your doctor about your health history. Eliquis may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Bleeding problems. Taking Eliquis raises your risk for bleeding. You shouldn’t take Eliquis if you currently have any bleeding problems, such as a bleeding stomach ulcer. If you have a history of bleeding problems, talk with your doctor about whether Eliquis is right for you.
  • Upcoming surgical, medical, or dental procedures. Taking Eliquis can raise your risk for bleeding with certain surgical, medical or dental procedures. To reduce the risk of bleeding, your doctor may recommend stopping Eliquis for a few days beforehand. If you’re planning to have a procedure, check with your doctor if you’ll need to stop taking Eliquis. Your doctor may have you take a different drug to prevent blood clots while you’re not taking Eliquis. And they’ll also tell you when to start taking Eliquis again.
  • Triple-positive antiphospholipid syndrome (APS). You shouldn’t take Eliquis if you have triple-positive APS because it may raise your risk for blood clots. With this condition, your blood has tested positive for lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein antibodies. If you have triple-positive APS, ask your doctor about other medications that may be better options for you.
  • Allergic reaction. If you’ve ever had a severe allergic reaction to Eliquis or any of its ingredients, you shouldn’t take Eliquis. Ask your doctor about other medications that may be better options for you.
  • Artificial heart valve. Eliquis is not recommended if you’ve had a heart valve replacement. The drug hasn’t been studied in people with an artificial heart valve. Ask your doctor about other medications that may be better options for you.
  • Pulmonary embolism (PE) that needs treatment with surgery or medications to dissolve the blood clot. Eliquis isn’t recommended for PEs that need treatment with either surgery to remove the clot or medications to dissolve the clot. If you’re taking Eliquis to treat a PE, talk with your doctor about whether Eliquis is right for your situation.
  • Kidney problems. Ifyour kidneys don’t work well, levels of Eliquis can build up in your body. This can raise your risk for side effects. If you’re using Eliquis to treat or prevent DVT or PE, your dosage doesn’t need to be adjusted. But a lower dosage is recommended if you’re using Eliquis to prevent blood clots and stroke with AFib and you’re age 80 years or older or weigh 132 pounds (60 kilograms) or less.
  • Liver problems. If your liver doesn’t work well, levels of Eliquis can build up in your body. This can raise your risk for side effects. In addition, Eliquis hasn’t been studied in people who have blood clotting problems related to liver disease. Eliquis is not recommended for people with severe liver problems. If you have any liver issues, talk with your doctor about whether Eliquis is right for you.
  • Pregnancy. It’s not known if Eliquis is safe to take during pregnancy. For more information, see the “Eliquis and pregnancy” section above.
  • Breastfeeding. It’s not known if Eliquis is safe to use while breastfeeding. For more information, see the “Eliquis and breastfeeding” section above.

Note: For more information about the potential negative effects of Eliquis, see the “Eliquis side effects” section above.

When you get Eliquis from the pharmacy, the pharmacist will add an expiration date to the label on the packet. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Eliquis tablets should be stored at room temperature in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Eliquis and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Eliquis is approved for use in adults to:

  • reduce the risk of stroke and systemic embolism in people with nonvalvular atrial fibrillation (AFib)
  • treat deep vein thrombosis (DVT)
  • treat pulmonary embolism (PE)
  • reduce risk of DVT and PE recurrence following initial treatment
  • prevent DVT that could lead to PE in people who have had hip or knee replacement surgery

Half-life

Eliquis has an apparent half-life of 12 hours.

Administration

Eliquis is taken orally twice a day.

Mechanism of action

Eliquis is a direct-acting oral anticoagulant (DOAC). It contains the active drug apixaban, a selective inhibitor of blood clotting factor Xa. Apixaban binds to and inhibits free and clot-bound factor Xa. This reduces the formation of thrombin, and subsequently fibrin, in the clotting cascade. Fibrin binds platelets together to form clots, so apixaban reduces clot formation.

Pharmacokinetics and metabolism

At oral doses of up to 10 mg, Eliquis has an absolute bioavailability of approximately 50%. Absorption is not affected by food. Cmax is reached approximately 3 to 4 hours after dosing.

Eliquis is approximately 87% bound to plasma proteins.

Approximately 25% of the dose is metabolized to inactive metabolites, predominantly by CYP3A4. Apixaban and its metabolites are excreted via the bile in the feces, and in urine (approximately 27% renal clearance).

Contraindications

Eliquis in contraindicated in people with:

  • active bleeding
  • a history of severe hypersensitivity to Eliquis, such as anaphylaxis

Storage

Store Eliquis at room temperature (68°F to 77°F/20°C to 25°C). Excursions are permitted at temperatures of 59°F to 86°F (15°C to 30°C).

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 other 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.