Side Effects of Eliquis: What You Need to Know

Triple-positive antiphospholipid syndrome (APS). People with triple-positive APS may have an increased risk of blood clots from Eliquis. Before starting Eliquis treatment, tell your doctor if you have triple-positive APS. They’ll likely recommend a medication other than Eliquis for your condition.

Eliquis – Uses, Side Effects, and More

Apixaban is used to prevent serious blood clots from forming due to a certain irregular heartbeat (atrial fibrillation) or after hip/knee replacement surgery. With atrial fibrillation, part of the heart does not beat the way it should. This can lead to blood clots forming, which can travel to other parts of your body (such as the lungs or legs) or increase your risk for stroke. In the United States, apixaban is also approved to treat certain types of blood clots (deep vein thrombosis-DVT, pulmonary embolus-PE) and to prevent them from forming again.

Apixaban is an anticoagulant that works by blocking certain clotting proteins in your blood.

Warnings:

Do not stop taking apixaban unless directed by your doctor. If you stop taking this medication early, you have a higher risk of forming a serious blood clot (such as a stroke, blood clot in the legs/lungs). Your doctor may direct you to take a different “blood thinning” or antiplatelet medication to reduce your risk. Get medical help right away if you have weakness on one side of the body, trouble speaking, sudden vision changes, confusion, chest pain, trouble breathing, pain/warmth/swelling in the legs.

People taking this medication may bleed near the spinal cord after certain spinal procedures. Bleeding in this area can cause paralysis that lasts a long time or could become permanent. Ask your doctor about the benefits and risks before any spinal procedure. The risk of bleeding may be higher if you have a deformed spine, or have had spinal procedures/surgery before (such as epidural catheter placement, difficult epidural/spinal puncture), or are taking other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, “blood thinners” such as warfarin/enoxaparin, nonsteroidal anti-inflammatory drugs-NSAIDs such as ibuprofen). Tell your doctor right away if you notice symptoms such as back pain, leg numbness/tingling/weakness, loss of control of the bowels or bladder (incontinence).

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How to use Eliquis

See also Warning section.

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking apixaban and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with or without food as directed by your doctor, usually twice daily (every 12 hours). If you cannot swallow the tablet whole, you may crush the tablet and mix with water, apple juice, or applesauce and take it right away.

The dosage is based on your medical condition, age, weight, kidney function, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). If you are taking apixaban to prevent blood clots from forming after surgery, the length of treatment is based on the type of surgery that you had.

Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Do not run out of this medication. Order your refills early to avoid running out of pills.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

Side Effects

See also Warning section.

Nausea, easy bruising, or minor bleeding (such as nosebleed, bleeding from cuts) may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication can cause serious bleeding if it affects your blood clotting proteins too much. Tell your doctor right away if you have any signs of serious bleeding, including: nosebleeds that happen often or don’t stop, unusual tiredness/weakness, unusual pain/swelling/discomfort, unusual bruising, prolonged bleeding from cuts or gums, unusually heavy/prolonged menstrual flow, pink/dark urine, coughing up blood, vomit that is bloody or looks like coffee grounds, severe headache, dizziness/fainting, bloody/black/tarry stools, difficulty swallowing.

Get medical help right away if you have any signs of very serious bleeding, including: vision changes, confusion, trouble speaking, weakness on one side of the body.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking apixaban, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, bleeding problems (such as bleeding of the stomach/intestines, bleeding in the brain), blood disorders (such as anemia, hemophilia, thrombocytopenia), recent major injury/surgery, stroke, a certain clotting disorder (antiphospholipid syndrome), frequent falls/injuries.

Before having surgery or any medical/dental procedures (especially spinal puncture or spinal/epidural anesthesia), tell your doctor or dentist that you are taking this medication and about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor or dentist may tell you to stop taking apixaban before your surgery. Ask for specific instructions about stopping or starting this medication.

This medication may cause stomach bleeding. Daily use of alcohol while using this medicine will increase your risk for stomach bleeding. Limit alcoholic beverages. Ask your doctor or pharmacist about how much alcohol you may safely drink.

This medication can cause bleeding. To lower the chance of getting cut, bruised, or injured, use great caution with sharp objects like safety razors and nail cutters. Use an electric razor when shaving and a soft toothbrush when brushing your teeth. Avoid activities such as contact sports. If you fall or injure yourself, especially if you hit your head, contact your doctor right away. Your doctor may need to check you for hidden bleeding that could be serious.

During pregnancy, this medication should be used only when clearly needed. Apixaban may increase the risk of bleeding in the pregnant woman, the unborn baby, and the newborn baby. Discuss the risks and benefits with your doctor. Your doctor may switch the type of medication you use during pregnancy.

It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Consult your pharmacist or physician.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: mifepristone, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, “blood thinners” such as warfarin, enoxaparin), certain antidepressants (including SSRIs such as fluoxetine, SNRIs such as desvenlafaxine/venlafaxine).

Other medications can affect the removal of apixaban from your body, which may affect how apixaban works. Examples include certain azole antifungals (such as itraconazole, ketoconazole, posaconazole), conivaptan, HIV protease inhibitors (such as lopinavir), rifamycins (such as rifabutin), ritonavir, St. John’s wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen, naproxen) that may increase your risk for bleeding if taken together with this medication. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Side Effects of Eliquis: What You Need to Know

If you need to take a medication to prevent or treat blood clots, your doctor might suggest Eliquis.

It’s a prescription drug used in adults to prevent or treat blood clots in certain situations. Examples of the blood clots Eliquis treats include deep vein thrombosis (DVT) and pulmonary embolism (PE). It’s also used to prevent blood clots and stroke in people with a certain kind of atrial fibrillation.

Eliquis comes as a tablet that you swallow, and its active ingredient is apixaban. An active ingredient is what makes a drug work. You may hear this medication referred to as a blood thinner.

Depending on what you’re using Eliquis for, you may take it short term or long term. Your doctor can recommend how long you’ll need to take the drug.

For more information about Eliquis, including details about its uses, see this in-depth article.

Like other drugs, Eliquis can cause mild to serious side effects, also called adverse effects. Keep reading to learn more.

Some people may experience mild to serious side effects during their Eliquis treatment. Examples of commonly reported side effects of Eliquis include:

• nausea
• bleeding
• anemia (low red blood cell level)
• bruising*

* To learn more about this side effect, see the “Side effects explained” section below.

Examples of mild side effects that have been reported with Eliquis include:

• nausea
• bleeding
• anemia (low red blood cell level)
• thrombocytopenia (low levels of platelets, a kind of blood cell that helps form blood clots)
• nosebleeds*
• bruising*
• mild allergic reaction*

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And don’t stop taking Eliquis unless your doctor recommends it.

Eliquis may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Eliquis, visit MedWatch.

Mild side effects are common in people taking Eliquis. But it’s also possible to develop serious side effects from this medication. Serious side effects that have been reported with Eliquis include:

• serious bleeding
• risk of blood clots if stopping Eliquis treatment early*
• risk of spinal blood clots from certain spinal procedures*
• severe allergic reaction†

* Eliquis has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.

If you develop serious side effects while taking Eliquis, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Get answers to some frequently asked questions about the side effects of Eliquis.

Do older people have a higher risk of side effects from Eliquis?

No, older people do not seem to have a higher risk of side effects from Eliquis than younger people.

In studies, the majority of people taking Eliquis were ages 65 years and older. The studies did not find an increased risk of Eliquis side effects in older people when compared with younger people.

But older people are more likely to have medical conditions than younger people. Having certain medical conditions may increase the risk of side effects from taking Eliquis. For more information, see the “Warnings for Eliquis” section below.

If you have questions about your risk of side effects from Eliquis, ask your doctor.

Am I at higher risk of side effects if I take the 5-mg strength of Eliquis?

Yes, you may be at a higher risk of side effects if you take a higher strength of Eliquis.

The drug is available in strengths of 2.5 milligrams (mg) and 5 mg. You’ll take Eliquis twice per day. But depending on the dosage your doctor prescribes for your condition, you may take as much as 20 mg per day.

If you’re concerned about side effects that you may have while taking a higher dosage of Eliquis, talk with your doctor or pharmacist. They can discuss your risk of side effects with you.

Can stopping Eliquis treatment suddenly cause side effects, such as withdrawal symptoms?

No, you shouldn’t experience withdrawal symptoms if you stop taking Eliquis suddenly. But stopping Eliquis treatment suddenly can increase your risk of blood clots.

In fact, Eliquis has a boxed warning for the risk of blood clots if you stop Eliquis too early. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous. For more information on this boxed warning, see the “Side effects explained” section below.

You shouldn’t stop taking Eliquis suddenly without talking with your doctor. They’ll be able to recommend when to stop taking the drug. If you do need to suddenly stop taking Eliquis, your doctor may suggest a different medication for your condition.

Does Eliquis cause kidney-related side effects?

It’s possible for Eliquis to cause kidney-related side effects. But kidney-related side effects were not commonly reported in studies of the drug.

In rare cases, Eliquis may cause serious bleeding. This includes bleeding in your organs, such as your kidneys.

Another rare side effect of Eliquis is blood in the urine, which could be due to a kidney-related problem.

If you’re concerned about kidney-related side effects occurring during Eliquis treatment, talk with your doctor or pharmacist.

Learn more about some of the side effects Eliquis may cause.

Risk of blood clots if stopping Eliquis treatment early

Eliquis has a boxed warning for the risk of blood clots if stopping Eliquis treatment early. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.

Eliquis works to prevent blood clots from occurring or to treat a blood clot that you already have. But if you stop taking Eliquis before it’s recommended, you may have an increased risk of blood clots.

What might help

Don’t stop taking Eliquis without first talking with your doctor. If you do need to stop treatment with Eliquis, your doctor may recommend that you take a different blood thinner. This can help to prevent blood clots.

For more information about this side effect, talk with your doctor or pharmacist.

Risk of spinal blood clots from certain spinal procedures

Eliquis has a boxed warning for the risk of spinal blood clots from certain spinal procedures. Boxed warnings are the most serious warnings from the FDA. They alert doctors and patients about drug effects that may be dangerous.

Having certain spinal procedures during Eliquis treatment may increase the risk of blood clots in your spine. Symptoms of blood clots in your spine include:

• numbness or weakness in your legs
• tingling
• bladder or bowel problems

What might help

Before having any spinal procedures done, tell your doctor that you’re taking Eliquis. They may recommend scheduling your procedure when you’ll have the least amount of Eliquis in your body. This can help decrease your risk of spinal blood clots.

Your doctor will also monitor you for symptoms of blood clots after you have a spinal procedure. If you have any of the symptoms listed above, contact your doctor or go to a hospital right away.

If you have concerns about risk of spinal blood clots during Eliquis treatment, talk with your doctor or pharmacist.

Nosebleeds

You may have nosebleeds during your treatment with Eliquis. But in studies, nosebleeds were not a commonly reported side effect in people taking Eliquis.

What might help

If you have nosebleeds during your treatment with Eliquis, talk with your doctor. They may be able to recommend ways to treat this side effect. For example, they may recommend using saline nasal spray to help moisten your nose, which may prevent nosebleeds.

Bruising

When you take Eliquis, you may notice that you bruise easier or more often than usual. Bruising was a common side effect reported by people in studies of Eliquis.

What might help

If you notice bruising during your treatment with Eliquis, talk with your doctor. If this side effect is severe or bothersome to you, your doctor may be able to recommend ways to help prevent it.

Allergic reaction

Like most drugs, Eliquis can cause an allergic reaction in some people.

Symptoms can be mild to serious and can include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

• an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Eliquis, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Eliquis, they may have you switch to a different treatment.

• what dose of the drug you were taking when you had the side effect
• how soon you had the side effect after starting that dose
• what your symptoms were
• how it affected your daily activities
• what other medications you were taking
• any other information you feel is important

Eliquis comes with several warnings, which may affect whether the drug is a good treatment for your condition.

Before you start treatment with Eliquis, tell your doctor about any medical conditions that you have. This can help them determine if the drug is a safe treatment option for you.

Boxed warnings

Eliquis has boxed warnings for the risk of blood clots if stopping Eliquis treatment early and risk of spinal blood clots from certain spinal procedures. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.

• Risk of blood clots if stopping Eliquis treatment early. You may have an increased risk of blood clots if you stop taking Eliquis early. It is not recommended that you stop taking this medication without first talking with your doctor.
• Risk of spinal blood clots from certain spinal procedures. If you’re taking Eliquis, you may have an increased risk of spinal blood clots after certain spinal procedures. Before you have any spinal procedures, tell your doctor that you’re taking Eliquis.

To learn more, see the “Side effects explained” section above.

Other warnings

Eliquis may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Eliquis is a good treatment option for you.

Talk with your doctor about your health history before starting Eliquis. The list below includes factors to consider.

Artificial heart valve. It’s not known whether it’s safe for people with an artificial heart valve to take Eliquis. If you have an artificial heart valve, your doctor will likely not prescribe Eliquis. They’ll recommend a different medication to take for treating or preventing blood clots.

Upcoming surgical or dental procedures. Tell your doctor if you have any upcoming surgeries or dental procedures while you’re taking Eliquis. This medication is a blood thinner and increases your risk of bleeding. Due to this risk, your doctor may recommend stopping Eliquis at a certain time before your procedure to prevent bleeding. It’s recommended that you do not stop taking Eliquis without first talking with your doctor. They can determine the best treatment plan for you.

Bleeding disorders. This medication can increase your risk of bleeding. If you have a bleeding disorder, you may have a higher risk of bleeding with Eliquis. Before you start taking this drug, tell your doctor about any bleeding disorder you have. This can help them determine whether it’s safe for you to take Eliquis with your condition.

Allergic reaction. If you’ve had an allergic reaction to Eliquis or any of its ingredients, your doctor will likely not prescribe Eliquis. Ask them what other medications are better options for you.

Triple-positive antiphospholipid syndrome (APS). People with triple-positive APS may have an increased risk of blood clots from Eliquis. Before starting Eliquis treatment, tell your doctor if you have triple-positive APS. They’ll likely recommend a medication other than Eliquis for your condition.

Kidney problems. If you have kidney problems, tell your doctor before starting Eliquis. If your kidneys aren’t working properly, this medication can build up in your body. Having too much Eliquis in your body may increase your risk of side effects. If you have kidney problems, your doctor may recommend a lower dose of Eliquis for you. Talk with your doctor about the best treatment plan for you.

Liver problems. Eliquis can build up in your body if your liver isn’t working properly. Having too much Eliquis in your body may increase your risk of side effects. If you have liver problems, tell your doctor before you start taking this drug. This will help them determine if Eliquis may be a safe treatment option for you. In some cases, they may recommend a different medication.

Active bleeding. If you have any active bleeding, your doctor will not recommend that you start taking Eliquis. This medication can increase your risk of bleeding and may make active bleeding worse. Your doctor will recommend treating the bleeding before you start treatment with Eliquis.

Alcohol and Eliquis

There aren’t any known interactions between Eliquis and alcohol.

But alcohol can increase your risk of bleeding. Since Eliquis can also cause bleeding, drinking alcohol while taking Eliquis may further increase your risk of bleeding.

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

Pregnancy and breastfeeding while taking Eliquis

It’s not known if it may be safe to take Eliquis during pregnancy or while breastfeeding.

At this time, there’s not enough information to know whether Eliquis may cause harm to a developing fetus. But it’s possible that taking Eliquis during pregnancy may increase the risk of bleeding. So Eliquis is currently not recommended for use during pregnancy.

If you’re taking Eliquis and need an epidural injection for pain relief during labor, you may have an increased risk of developing a spinal blood clot. Eliquis has a boxed warning for this risk. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous. For more information, see the “Side effects explained” section above.

It’s not known if Eliquis may be present in breast milk or may have an effect on a child who is breastfed. Because it’s not known if breastfeeding while taking Eliquis is safe, it’s currently not recommended.

If you’re pregnant or breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor. They’ll discuss whether Eliquis may be a safe treatment option for you.

You may experience side effects during your treatment with Eliquis. Most of the drug’s side effects are mild. But it’s also possible to have serious side effects from this medication.

Before you start treatment with Eliquis, talk with your doctor about the possible side effects of this medication. Here are some questions to help get you started:

• What should I do if I become pregnant during Eliquis treatment?
• Is my risk of side effects increased due to other medications that I’m taking?
• How do the side effects of Eliquis compare with side effects of other medications used for my condition?
• Is my risk of bleeding higher when I first start Eliquis?

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Disclaimer: Healthline 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.

Last medically reviewed on July 21, 2022