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Eliquis Side Effects

Eliquis and similar anticoagulants can cause side effects, both mild and severe. Although not frequent, fatigue, nausea and other minor effects have been reported. People taking Eliquis have also reported severe bleeding and liver damage. The blood thinner has also been linked to blood clots and an increased risk of stroke when the medication is discontinued.

Last Modified: August 17, 2020
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People taking Eliquis may experience side effects such as headaches, dizziness, fatigue, nausea, gastrointestinal discomfort, joint pain, and rash. The National Institutes of Health reported that after the drug was approved in 2012, reports of mild liver injury occurred, stating “liver injury arose within days of starting apixaban.”

Severe allergic reactions to Eliquis, which cause chest pain, swelling of the face or tongue, labored breathing and dizziness, are a medical emergency. Anyone experiencing these symptoms should call their doctor or 911 immediately.

Dangerous, possibly fatal, adverse events have been associated with Eliquis. The blood thinner can cause bleeding within the skull, hemorrhagic stroke, or gastrointestinal bleeding. Patients taking Eliquis also experienced bleeding at surgical sites following hip or knee replacement surgeries.

Unless the antidote — which is not widely available — is administered, effects should be expected to persist for at least 24 hours after the last dose of the medication is administered.

Patients who stop taking the drug prematurely are also at an increased risk of blood clots and other thrombotic events, such as stroke, while patients who undergo certain spinal or epidural procedures can develop hematomas that can result in long-term or permanent disability and death.

Taking Eliquis Safely

Anticoagulants come with risks, but there are steps you can take to prevent injuries related to serious and common side effects.

Although patients taking Eliquis aren’t required to have their bleeding time monitored the way those taking warfarin are, it’s important to take your dose regularly and inform your doctor — and medical professionals you see for other conditions — about all the medications you are taking. Other drugs may interact with Eliquis.

The Agency for Healthcare Research and Quality offers safety tips and a list of signs and symptoms that may require medical attention.

Common side effects of Eliquis include:

  • Chest pain or tightness
  • Excessively heavy menstrual bleeding
  • Red or brown urine
  • Swelling of the face or tongue
  • Bruising
  • Dizziness
  • Bleeding from nose or gums
  • Difficulty breathing, wheezing

If you notice any of these symptoms, call your doctor.

Injury prevention is crucial for people who take Eliquis or similar blood thinners because even minor injuries can result in internal bleeding. Be careful when using sharp objects, always wear shoes, and avoid sports and activities that can cause trauma to any part of your body.

Additionally, follow your doctor’s orders regarding your diet. Unlike warfarin, Eliquis is not affected by vitamin K, but if you are concerned about what you are eating or if you have stomach discomfort that makes it hard to eat a balanced diet, call your doctor.

Blood Clots with Early Discontinuation

When a patient stops taking Eliquis prematurely, or suddenly, they are at an increased risk of developing blood clots, according to a black box warning contained in drug labeling for the drug.

Typically, a blood clot forms to stop bleeding when a blood vessel is injured. After the bleeding stops and the area of the body where the bleed occurred is healed, the body breaks down and removes the clot naturally.

But when the blood clots too much or abnormally, or when certain conditions prevent the body from dissolving blood clots properly, blood clotting can become excessive and dangerous.

According to the drug’s label, clinical trials showed an increased rate of stroke observed among patients with atrial fibrillation transitioning from Eliquis to warfarin.

Risk of Spinal or Epidural Blood Clots

Patients who receive spinal or epidural anesthesia or undergo spinal puncture while taking Eliquis, are at risk of developing an epidural or spinal hematoma, or blood clot.

Either type of blood clot can result in long-term or permanent paralysis, according to drug labeling containing a black box warning for Eliquis.

Factors that can increase a patient’s risk of developing an epidural or spinal hematoma include:

  • Use of indwelling epidural catheters
  • Use of Eliquis with other drugs that affect hemostasis (the process that causes bleeding to stop), such as nonsteroidal anti-inflammatory drugs (NSAIDs), platelet inhibitors or other anticoagulant drugs
  • History of traumatic or repeated epidural or spinal punctures
  • History of spinal deformity or spinal surgery

Optimal timing between taking Eliquis and undergoing a neuraxial procedure is unknown.

epidural hematoma x-ray
Epidural Hematoma
spinal compression x-ray
Spinal Hematoma

Spinal hematomas have also occurred spontaneously in patients taking Eliquis who have not undergone spinal procedures or anesthesia.

A 2018 article in Case Reports in Hematology describes a 75-year-old “previously healthy” woman who developed bruising along her arms and partial paralysis of her leg. The problem started 10 days after an emergency-room doctor had switched her from Pradaxa to Eliquis.

Subsequent testing revealed the woman had developed a subdural hemorrhage that had spread through several regions of her spine, resulting in spinal cord compression. The patient required two spinal surgeries to resolve the complication.

Six months after surgery, the patient was “able to walk alone with the aid of a stick.” But the authors of the study warned that serious spinal hematomas are a “devastating complication” of apixaban and rivaroxaban therapy that requires prompt diagnosis and “early surgical evacuation of the hematoma.”

If not treated swiftly and properly, a spinal or epidural hematoma can be deadly. While it is possible to recover fully from the condition, hematomas of this nature can result in permanent damage to the brain and long-term disability.

Please seek the advice of a medical professional before making health care decisions.
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