As is the case with any other medication, there may be some instances where Eliquis (apixaban) interactions can occur. In such cases, use is not recommended or usage will have to be adjusted in order to prevent or reduce the risk of negative interactions occurring from other drugs, medical conditions, or even food and drink.
Drug Interactions
According to the FDA, drugs that may interact with Eliquis include the following.
- Strong dual inhibitors of CYP3A4 and P-gp may increase the risk of bleeding.
- Strong dual inducers of CYP3A4 and P-gp may increase the risk of thromboembolic events, including stroke, since they decrease the effectiveness of Eliquis.
Please note that this list may not be complete, and other interactions with drugs not listed here may occur.
Ibuprofen
The use of ibuprofen and Eliquis may raise the risk of bleeding, which can be severe in some individuals. These medications should not be used together due to potentially dangerous interactions.
Tylenol (Acetaminophen)
Interactions between Tylenol and Eliquis have not been found. However, individuals should discuss the safety of using Eliquis and Tylenol with their doctor before doing so.
Aspirin
The use of aspirin and Eliquis may increase the risk of having severe and potentially fatal bleeding. Individuals should not take these medications together due to these risks and should always let their doctor know about any pain relievers or other medications they’re taking with Eliquis.
Antibiotics
Certain antibiotics, such as clarithromycin, might raise blood levels of Eliquis and should be used with caution. Individuals taking both of these medications might require frequent monitoring, since they may have a higher risk of bleeding and other complications.
Antacids
Some antacid products contain aspirin, which may increase the risk of severe and potentially fatal bleeding in those who take Eliquis. Individuals should read labels carefully and not take antacids containing aspirin if they take Eliquis.
Indomethacin
Indomethacin is a non-steroidal anti-inflammatory drug (NSAID). The use of NSAIDs and Eliquis may lead to a higher risk of severe bleeding. Individuals should not take Indomethacin if they are taking Eliquis.
Rifampin
Rifampin is a CYP3A4 and P-gp inducer, which can decrease the effectiveness of Eliquis. In fact, this medication may reduce the effectiveness of Eliquis by as much as 50 percent. Individuals should discuss these risks with their doctor before taking Rifampin and Eliquis.
Meloxicam
Meloxicam is a non-steroidal anti-inflammatory medication (NSAID) that may increase the risk of severe bleeding when taken with Eliquis. Individuals should avoid taking Meloxicam and Eliquis together without their doctor’s approval.
Food Interactions
Sometimes the foods we eat and the beverages we drink can also interact with our medications. Food and drink that may interact with Eliquis include:
- There are no known interactions between certain foods and Eliquis, although some foods, such as grapefruit, might affect the effectiveness of this medication.
Please note that this list may not be complete, and there may be other foods and beverages that interact with this drug.
Eliquis and Alcohol
For more information, please visit our page on Eliquis and alcohol interactions.
Vitamins and Supplements
Individuals who are taking certain vitamins and supplements should talk to their doctor before taking Eliquis. Some vitamins and supplements, such as fish oil and vitamin E, may increase the risk of bleeding when taken with Eliquis.
Herbs
Certain types of herbs, such as St. John’s wort, are CYP3A4 inducers. These herbs may slow the effectiveness of Eliquis and may increase the risk of thromboembolic events, including stroke. Other herbs may also be associated with a higher risk of bleeding, such as ginseng, cat’s claw, and garlic.
Fish Oil
Fish oil contains omega-3 polyunsaturated fatty acids. When taking fish oil with Eliquis, you may experience an increased risk of bleeding.
Grapefruit and Grapefruit Juice
Grapefruit and grapefruit juice contain compounds that might increase the levels/effects of Eliquis. This may lead to higher amounts of Eliquis in your blood, which can raise the risk of bleeding and other side effects.
Coffee and Caffeine
There are no known interactions between coffee or caffeine and Eliquis. Individuals should discuss safety concerns about coffee or caffeine and Eliquis with their doctor.
Disease & Conditions Interactions
Sometimes certain medications can increase the risk of negative side effects for patients with certain diseases or other medical conditions. According to the FDA, diseases and medical conditions that are known to negatively interact with Eliquis include:
- Moderate or severe liver disease, since the risk of bleeding may be higher when taking this medication.
- Valvular heart disease, since there is no data on the safety of using Eliquis in individuals with prosthetic heart valves.
Please note that this list may not be complete, and there may be other diseases and medical conditions where patients should not take this medication.
Dizziness
Eliquis may cause dizziness as a side effect in some individuals. While this side effect is rare, those who have dizziness, especially sudden dizziness, while taking Eliquis should seek immediate medical care. Dizziness can be a sign of bleeding.
Eliquis and Pregnancy
For more information, please visit our page on Eliquis and pregnancy risks.
Other Interactions
Other potential interactions include the following:
Surgery
Individuals who are having spinal procedures done are at risk of developing spinal/epidural hematoma when taking Eliquis. These may lead to permanent or long-term paralysis. Patients might need to temporarily stop the use of Eliquis before surgery or take a different anticoagulant medication, depending on their doctor’s recommendations.
Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.
