Your blood is made to clot to restrict its loss through a cut or wound. It is a process wherein your blood turns from a liquid-state to a gel-type of substance. However, a blood clot inside your vein can turn into a serious condition. It can even lead to a near-fatal situation. Blood clot can be static or dynamic; a static clot may not cause a major problem. But, a clot that freely circulates may block a vessel. A dynamic clot can thus result in blood circulation problems. In short, it turns into a condition needing medical attention on an emergency basis. Your doctor may prescribe drugs which can reduce the risks of likely clotting of blood. These drugs can thus help avoid potential risks such as strokes. Eliquis is a drug widely used for the management of clotting of blood – especially in your lungs or legs. This drug may trigger a few undesired side effects. A proper understanding of its side effects can help manage them effectively.

The generic form of eliquis is known as apixaban. It falls under a category called anticoagulant drugs. Its main use is to avoid likely risks of clotting of blood. Timely prevention of blood clots can help avoid irregular or erratic heartbeats, strokes as well as other dangerous medical conditions. Doctors increasingly use it to avoid clotting soon after a knee or hip replacement procedure; it is administered especially to people who have had prior episodes of blood clots.

Eliquis works by controlling a catalyst which enables clotting of blood. The catalytic agent – known as factor-Xa, is responsible for enzymes required in the blood clotting process. Contrary to popular belief, eliquis does not play any role in aggregation of platelets. The drug has its use in treating conditions like deep vein thrombosis as well as embolism (a block) in lungs. It is also used for the relapse of these conditions soon after an emergency treatment has been administered. This drug has been used for the above purposes since mid-2011. Soon after its introduction, it was put to use for a wide range of conditions such as defibrillation (atrial), thrombosis, embolism (pulmonary), etc.

Side effects of eliquis

Eliquis is consumed orally either before or after a meal. Its dosage plan is as per the advice of your treating physician; however, the common dosage form is once in twelve (12) hours. It is generally not advised to swallow the pill as a whole; instead, it is a good practice to crush the pill and take it either with water or fresh juice (for instance, apple-juice or apple-sauce). The strength of your dose depends on the severity of the clinical condition, bodyweight, renal health, age, current medications taken or treatment plans pursued, etc.

Common side effects

Most common side effects of this drug include bruising, bleeding (mildly) and nausea. As mentioned, milder levels of bleeding may be noticed either from cuts or from your nose. These side effects are experienced only over a shorter period of time. However, if you notice these side effects to persist for a longer time-span, you need to seek medical help as quickly as possible. You also need to note that eliquis may trigger an acute bleeding condition if it influences your clotting mechanism deeply. Such a near-fatal condition may occur when this drug disrupts the proteins catalysing the blood clotting process.

Serious side effects of eliquis

A few serious side effects include formation of bruises, difficulties in stoppage of blood bleeding from gums or from a cut, excessive discharge of fluids during menstrual cycles, severe headaches, weariness, discoloration of stool, nosebleeds (these can become serious if experienced very often), inflammation, pain as well as darkened urine. In some cases, people have also noticed traces of blood in vomit, problems faced while swallowing food, passing out, fainting, etc. You are advised to take medical attention as soon as possible. Similar caution is needed if the signs include speaking difficulties, blurring of eyesight, being in a confused state of mind, weariness – especially over one-side of the body, excessive bleeding from the injection-site, a tingling sensation in your legs, numbing of feet or other muscles, etc. It is also important to inform if you develop any nerve-related problems. Your doctor may recommend a prompt medical action if you are likely to develop neuro problems.

Possible allergic reactions

Very rarely, eliquis may trigger extremely acute allergic effects. It is hence important to tell your treating doctor as well as the pharmacist if you have any known allergies to eliquis or to any of its ingredients. Some acute allergic effects or reactions are respiratory problems, feeling dizzy, rashes on skin, severe spells of itchiness, inflammation as well as drowsiness. Another related reaction is the sudden swelling of facial organs or oral parts such as throat, tongue, etc. Upon sensing any of these allergies, you are advised to take immediate care under a qualified medical practitioner.

Side effects of a likely overdose of eliquis

The commonly prescribed dosage level is 2.5 mg; the dosage form is taken 2 times per day. The dosage levels of eliquis are monitored with closer attention if you are aged 75 years or more. Strength of dose is reduced if your bodyweight is less than 62 kilograms. Similar precaution is observed when your creatinine level (in serum) is more than 1.5 milligrams per deciliter (mg per dL). If you have accidentally missed a dose of eliquis, it is not recommended to take the forgotten dose along with the next dose. Such double dosage of eliquis can lead to a possible overdose. Also, if you have skipped a series of doses, you are advised to contact your pharmacist to reschedule the entire dosage plan.

In the event of an overdose of eliquis, you may experience signs such as discolored urine, darkened stool, respiratory problems such as longer cycles of breathing, fainting or passing out. If you suspect an overdose, you are advised to take medical help as soon as you can. If you live in the US, you are advised to get in touch with the contact coordinates of food and drug administration (FDA) or contact 911 without any further delay. On the other hand, if you are a resident of Canada, you can reach out to a local poison control center or contact Health Canada soon.

Precautions you can take for the safer consumption of eliquis

Foremost of all, you need to inform your treating physician if you are hypersensitive to eliquis. There can also be a few passive ingredients which you may be allergic to. Such not-so active substances present in eliquis are magnesium-stearate, a few forms of cellulose, lactose (anhydrous genre), etc. Coating of this drug includes substances like titanium-dioxide, monohydrate of lactose, etc. It is a good practice to have an open discussion about prior allergies and hypersensitivities with your medical team.

Secondly, it is not a good practice to discontinue the intake of this drug without taking the consent of your physician. Such a sudden discontinuation may aggravate your medical condition. Similarly, you are advised to keep ample stock of this drug because running short of it can also aggravate your current medical condition. Above all, you are advised to take eliquis without any break as well as at the same timeslot each day. You need to note that your treating physician has advised you to take this medication as its benefits far exceed the risks or side effects it may trigger. However, most people who have consumed this drug have reported no major or very adverse side effects.

It is very important to tell your surgeon about the intake of eliquis; this information is a necessity when you are going to undergo a surgical intervention such as a puncture in the spinal area along with a spinal anesthesia, etc. This precaution is also necessary prior to having a dental procedure. It is very likely that your dental surgeon may advise you to discontinue the intake of eliquis a few days prior to the date of performing the dental procedure.

It is important to understand that the side effects, allergic reactions, etc. listed above do not represent a full list of such discomforts. If you develop newer signs and symptoms – i.e., apart from those provided above, you are advised to immediately get in touch with your treating doctor and the pharmacist. As the seriousness of such new signs may require a qualified medical professional to infer or qualify, it is highly recommended to take needful medical help without much delay.

Prior medical conditions or illnesses

In general, your treating physician will never prescribe this drug without understanding your prior illnesses or medical conditions. Your physician may also consider your family’s medical history as well as your own clinical history before administering eliquis. You need to inform your doctor about prior conditions such as renal dysfunction, liver disorders, blood-related ailments such as hemophilia, anemia, etc. You also need to share details about conditions such as prior episodes of intestinal bleeding or abdominal bleeding, incidence of strokes, blood-clot related problems, any major surgeries or injuries sustained recently.

Eliquis is likely to trigger bleeding in your abdomen, especially stomach. Your physician may hence advise you to discontinue the intake of alcohol as such habits may aggravate internal bleeding. It is also a good practice to limit your consumption of alcohol after understanding the safer levels of intake of such beverages. As mentioned, eliquis may trigger bruising and bleeding. You are hence advised to handle sharp appliances or equipment such as nail-cutters, razors, knives, etc. with added care. Your pharmacist or physician may tell you to use a brush with softer bristles to clean your teeth or use an electric shaver or razor. It is not a good practice to engage in contact-sports such as rugby, soccer, etc. where the odds of a bruise or an injury are relatively high. If you have had an accidental fall, you need to contact a qualified medical practitioner as early as possible. In some instances, a head injury without an apparent loss of blood may soon lead to a life-threatening condition.

Women who are pregnant or those who are planning to become pregnant need to take eliquis only if it is needed. As eliquis may lead to possible risks of bruises, it can trigger risks of internal bleeding. Such conditions can harm both the pregnant woman as well as her fetus. Neonatologists (specialists who care for newly born babies) observe that your new born may also suffer from bleeding issues if the mother had taken eliquis prior to delivering the baby. Also, women who are breastfeeding are advised not to take this drug as there is no scientific evidence for the safety of this drug when administered to nursing mothers. Since the baby’s health may be at risk, doctors generally do not advise intake of eliquis by breastfeeding or nursing women.

Likely, adverse interactions of eliquis with other medications

Drugs which may not trigger major side effects can cause a few adverse reactions when taken together with other medications. You are hence advised to maintain a list of all other medications you are currently consuming. While making this list, make sure you include prescribed drugs, over the counter (OTC) medicines, dietary supplements, herbal medicines, etc.

It is not a good practice to alter the medications consumed or abruptly discontinue the intake of them without telling your treating physician. For the same reason, it is also not advisable to start taking newer drug formulations without the consent of the medical team. Medications known for their interactions with eliquis include blood thinning drugs such as enoxaparin, warfarin, etc. You also need to be careful with anti-platelet medicines like clopidogrel, a few types of antidepressants – both selective serotonin reuptake inhibitors (SSRIs) as well as serotonin norepinephrine reuptake inhibiting drugs (SNRIs) – i.e., medicines such as venlafaxine, fluoxetine, etc.

Other drugs whose co-administration can lead to adverse interactions include antiviral drugs taken as part of a treatment plan for HIV AIDS, such as ritonavir; drugs which are prescribed for relaxing your muscles or those taken to treat epileptic fits or convulsions – medications like phenytoin, carbamazepine, etc. Your pharmacist may advise you not to take eliquis along with a few types of antifungal drugs – especially those falling under the azole genre of antifungal drugs. Medications categorized under this genre include ketoconazole, itraconazole, etc.

Apart from the above list of drugs, you also need to be cautious about taking medications which can enhance the risks of bleeding. It is highly recommended to read all the precautions and instructions listed on drugs’ labels or packaging before taking them along with eliquis. Drugs which may increase the chances of an internal bleeding include non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, etc. Similar level of caution is needed when taking fever relieving drugs or those which can give relief from pains; the most widely used drug – aspirin – needs to be taken only after checking with your pharmacist. For some people, intake of aspirin is essential to avoid a stroke or a cardiac arrest; such people are advised to talk to their physician for a lower dosage form (i.e., with a relatively lesser strength) of aspirin to keep related health risks at bay.

In general, you are advised not to share eliquis with a family member or a colleague who has a similar kind of medical condition. Your doctor may advise you to track the efficacy of this drug though periodic check-ups. The best way to know how the drug is working on your body is through tests like blood cell count – especially, the count of your red blood cells. The tests done may also include hematocrit or a count of haemoglobin. These tests can help monitor the status of your clinical condition, and above all, they tell you how well your body is responding to a dosage plan of eliquis.

In order to avoid any adverse side effects or loss in efficacy, eliquis needs to be kept in proper storage conditions. It is important to store this drug at ambient temperatures. You must also ensure that the place of storage must not be exposed to excessive moisture or to direct sources of light. Hence, it is not a good practice to keep in your toilet or bathroom (to avoid a likely exposure to moisture). It is equally important to keep it away from the reach of pets and children.

Eliquis is taken orally; though, it is commonly taken with a glass of water, some people may crush and consume it. While you crush it, it is recommended to mix it with apple juice or water, and drink it within 3 hours from the time of making the mix.

In sum, the commonly experienced side effects of eliquis are internal bleeding, bruising and a few abdominal discomforts such as nausea, vomiting, etc. These side effects are noticed only over a shorter span of time. But, if one or more of these side effects persist for a longer time, you need to ask for medical support as soon as possible. Some of the serious side effects of eliquis are excessive discharge during menstrual cycles, bruising, bleeding from gums or a cut, headaches, tiredness, discolored stool, swelling, darkened urine, etc.

Pregnant women need to take eliquis only if it is essential. As risks of internal bleeding are high, it can injure the fetus as well as the mother. Breastfeeding women are strongly advised not to take this medication; the safety levels of eliquis on nursing mothers are yet to be fully evidenced. As your baby’s health can also be at risk, doctors do not advise consumption of eliquis by women who are nursing their infants. If you need more inputs about safer intake of eliquis, you are advised to talk to your treating physician and your pharmacist.

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