What Drugs Should Not Be Taken With Eliquis?

Eliquis (apixaban) is a medication used to treat blood clots and prevent them. As with all medications, there are common side effects that are expected with Eliquis. Eliquis is an anticoagulant that is classified as a high-risk medication due to the risks of significant adverse events that are associated with this drug class. Being an anticoagulant, Eliquis can increase your risk of bleeding. Having certain health conditions or taking certain other medications can increase the risk of serious bleeding, which can lead to other health complications.

Please continue reading to learn more about Eliquis, what it is used for, and which medications should not be taken with Eliquis.

Is Eliquis a blood thinner or anticoagulant?

Eliquis is an anticoagulant, commonly referred to as a blood thinner, made by the pharmaceutical company Bristol Myers Squibb. It belongs to a group of drugs called factor Xa inhibitors.

There are two main types of blood thinners. These medications affect the blood clotting process in the body; they are used for treating or preventing blood clots:

Anticoagulants: These drugs interrupt the process of blood clot formation and make your blood less able to form clots. Examples of anticoagulant drugs include heparin, warfarin, apixaban (Eliquis), dabigatran (Pradaxa), and edoxaban (Savaysa).
Antiplatelet agents: These drugs prevent platelets from clumping together to form blood clots. Examples of antiplatelet drugs include acetylsalicylic acid (aspirin), clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta).

What is Eliquis used for?

Eliquis blocks the activity of certain natural substances in the blood that are responsible for clotting, with factor Xa being the main one. To reduce the risk of blood clotting, your doctor may prescribe Eliquis for the following conditions:

To prevent stroke and systemic embolism (blood clots) if you have nonvalvular atrial fibrillation, a heart rhythm disease causing an irregular heartbeat.
To prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) if you are having hip or knee replacement surgery. A DVT is a blood clot that usually forms in the leg but can form in other veins as well that are not superficial such as the arms. PE (pulmonary embolism) is a blood clot located in the veins of the lung.
To treat deep vein thrombosis (DVT) and pulmonary embolism (PE).
To prevent recurrent DVT and PE after initial treatment.

How to take Eliquis?

Eliquis comes in the form of an oral tablet in doses of 2.5 mg and 5 mg. This medicine is to be taken twice a day by mouth, with or without food. You should take Eliquis around the same time every day. If you have trouble swallowing tablets, you can crush an Eliquis tablet and mix it with water, apple juice, or applesauce. Be sure to consume the mixture immediately—do not store it for later use.

Take Eliquis exactly as prescribed. Read the instructions on your prescription label carefully. Ask your doctor or pharmacist to explain anything you don’t understand.

In case of a missed dose, take your Eliquis dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose according to your regular dosing schedule. Do not take two doses together to make up for a missed dose.

You should continue taking Eliquis unless your doctor tells you to stop. Stopping Eliquis too soon can put you at increased risk of life-threatening blood clotting.

What is the Eliquis dose for the prevention and treatment of blood clotting?

The usual dose of Eliquis in adults is 5 mg twice a day by mouth. A lower dose of 2.5 mg twice a day is recommended in people with creatinine less than 1.5mg/dL who are 80 years of age or older and have a weight of less than 60kg (132 pounds). 2.5mg twice a day is also used for those with a creatinine level above 1.5mg/dL who are 80 years of age or older and/or have a weight less than 60kg.

If you are taking Eliquis to prevent blood clots forming after hip or knee replacement surgery, your doctor will likely start you on this medicine 12 to 24 hours after your surgery. Eliquis is usually prescribed for 12 days after knee replacement surgery and 35 days after hip replacement surgery.

What are the side effects and risks of taking Eliquis?

Eliquis reduces blood clots forming and can lead to a higher risk of serious bleeding problems.

Call your doctor without delay if you experience any major bleeding or continuous minor bleeding, which includes bleeding gums, nosebleeds, heavy vaginal bleeding outside of the norm, coffee grounds vomit, blood in urine, red or pink-tinged urine, black or tarry stools, headache, or dizziness. Also, call your doctor without delay or seek emergency medical attention if you have signs and symptoms of allergic reactions such as skin rash, chest pain, swelling, or trouble breathing.

What drugs can interact with Eliquis?

Drug interactions between Eliquis and certain other medications can increase bleeding risk, cause serious side effects, or affect the overall dose needed of Eliquis to be therapeutic. You should alert your doctor when taking Eliquis with the following medications:

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Advil) and naproxen (Aleve)
Anti-seizure medications like carbamazepine (Tegretol, Carbatrol, Equetro, Epitol, Teril) and phenytoin (Phenytek, Dilantin)
Antibiotics like clarithromycin (Biaxin, in Prevpac) and rifampin (Rimactane, Rifadin, in Rifater)
Antifungal agents like ketoconazole (Nizoral) and itraconazole (Sporanox, Onmel)
Antiviral drugs like ritonavir (Norvir, in Kaletra)
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) (examples are fluoxetine (Prozac, Selfemra, Sarafem, in Symbyax), citalopram (Celexa), fluvoxamine (Luvox), sertraline (Zoloft), and paroxetine (Paxil, Brisdelle, Pexeva)), and serotonin norepinephrine reuptake inhibitors (SNRIs) (examples are venlafaxine (Effexor), desvenlafaxine (Pristiq, Khedezla), duloxetine (Cymbalta), and milnacipran (Savella, Fetzima))
St. John’s Wort

What are common Eliquis (apixaban) doses?

Nonvalvular atrial fibrillation: The usual dose of Eliquis is 5 mg twice a day in atrial fibrillation patients. Certain people must take only 2.5 mg twice a day of Eliquis (those 80 years or older, those with a body weight less than or equal to 60 kg, or those with serum creatinine more than or equal to 1.5 mg/dL).

Blood clot prevention in hip or knee replacement surgery patients: The usual dose of Eliquis is 2.5 mg twice a day. The first dose is taken at least 12 to 24 hours after the surgery. Doctors usually prescribe this medicine for 12 days after knee replacement surgery and 35 days after you have undergone hip replacement surgery.

Treatment of deep vein thrombosis and pulmonary embolism: Initial therapy with Eliquis is started at 10 mg twice a day for 7 days. After a higher initial dose, the dose is lowered to 5 mg twice a day.

Prevention of blood clots in people with a history of recurrent DVT and PE: The dose of Eliquis is usually 2.5 mg twice a day after a minimum of 6 months of treatment for a blood clot or pulmonary embolism.

Tips on using Eliquis safely

Tell your doctor if you have ever had an allergic reaction to Eliquis or any other medications.
Give your doctor a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. This can help avoid serious drug interactions between Eliquis and other drugs.
Give your healthcare professional a complete health history. Eliquis may not be right for people with certain medical conditions such as an artificial heart valve, bleeding problems, heavy bleeding, antiphospholipid syndrome, kidney disease, or liver disease.
Know that if you receive spinal anesthesia, an epidural, a spinal puncture (spinal tap), or other types of spinal surgery or spinal procedures while on apixaban, it can lead to the formation of a blood clot around the spinal cord. This can cause muscle weakness and paralysis. Tell your doctors you are on apixaban before any spinal procedure.
Make sure your healthcare providers know you are on apixaban before any surgery, including dental procedures. You may need to stop taking apixaban for a few days before surgery. Your doctor may ask you to switch to another anticoagulant in the lead-up to your procedure and go back on apixaban after your surgery.
Tell your doctor if you are pregnant or breastfeeding during Eliquis treatment.
Keep all your healthcare and laboratory appointments while on Eliquis. Your doctor may order blood tests to keep an eye on your risk of bleeding during treatment.
Call your doctor without delay if you experience any unusual bleeding or prolonged bleeding while taking Eliquis.