Eliquis (apixaban) is a type of direct oral anticoagulant (DOAC) that plays an important role in avoiding stroke and systemic embolism in individuals with atrial fibrillation, as well as in treating and preventing deep vein thrombosis (DVT) and pulmonary embolism (PE). It works by inhibiting Factor Xa, an enzyme essential for blood clot formation, thus reducing the risk of dangerous clotting events. However, as with any medication, Eliquis is associated with a range of potential side effects that patients should be aware of, particularly those who are older or have existing health conditions that may increase their risk.

Understanding the Eliquis side effects, both common and rare, is vital for patients to manage their health effectively while on this medication. This article will delve into the various side effects, focusing on the older population, and provide practical tips for managing these reactions. 

Common Side Effects

The most common side effects of Eliquis are related to its anticoagulant properties, meaning its primary effect—preventing blood clots—can also lead to bleeding complications. These bleeding-related side effects include:

  • Easy Bruising: Many patients on Eliquis notice that they bruise more easily than before. This occurs because the medication reduces the blood’s ability to clot, so even minor bumps can cause significant bruising.
  • Nosebleeds: Similarly, patients may experience frequent nosebleeds, especially during dry weather or if they have a history of nasal issues. To manage this, patients should avoid nasal irritants, utilize a humidifier to keep nasal passages moist, and apply gentle pressure to the nose during a bleed.
  • Prolonged Bleeding from Cuts: Any cuts or wounds may bleed longer than usual, requiring extra care to stop the bleeding. Applying steady pressure, keeping the wound clean, and seeking medical attention if the bleeding doesn’t stop are important steps to manage this side effect. 
  • Gastrointestinal Bleeding: Some patients might experience bleeding in the gastrointestinal (GI) tract, presenting as black, tarry stools or visible blood in the stool. GI bleeding can sometimes be severe, necessitating medical attention.
  • Nausea and Indigestion: Some patients report nausea, indigestion, or abdominal pain while taking Eliquis. These side effects are generally moderate but might be unpleasant for some individuals.

For elderly patients, these side effects may be more evident due to age-related changes in the body’s ability to metabolize and process medications. This population is also more likely to have comorbidities, such as kidney or liver disease, that can exacerbate these side effects. Proper Eliquis dosing is important to minimize risks, and closely monitoring symptoms while on this medication is crucial. 

Rare and Severe Reactions

While less common, Eliquis can cause serious side effects that require immediate medical attention. These include:

  • Major Bleeding Events: Although rare, severe bleeding can occur, particularly in the brain (intracranial hemorrhage), gastrointestinal (GI) tract, or other critical areas. Symptoms may include sudden headaches, vision changes, dizziness, or confusion. In the older population, the risk of significant bleeding is higher, especially if they have a history of stroke, peptic ulcers, or other bleeding disorders.
  • Allergic Reactions: Although uncommon, some patients may experience allergic reactions to Eliquis, which can manifest as a rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, or difficulty breathing. These symptoms warrant immediate medical attention.
  • Liver Problems: Though rare, Eliquis can cause liver damage. Symptoms of liver disorders include yellowing of the skin or eyes (jaundice), dark urine, severe stomach pain, and persistent nausea or vomiting. 
  • Kidney Issues: In some cases, Eliquis can affect kidney function, particularly in people with pre-existing kidney disease. Symptoms of renal disorders include variations in urine output and edema in the legs or feet, and persistent fatigue.
  • Dizziness and Fainting: Some patients, particularly the older population, may experience dizziness or fainting while on Eliquis. These symptoms can elevate the risk of falls and related injuries, such as fractures. It’s vital for patients experiencing these symptoms to move slowly when changing positions and to use support, such as a cane or walker, if necessary.

While Eliquis is highly effective in preventing and treating blood clots, patients must be aware of its potential side effects, both common and rare. Understanding these risks, especially for older individuals or those with existing health conditions, can help in managing the medication safely. Regular communication with healthcare providers, prompt reporting of any unusual symptoms, and careful adherence to Eliquis prescribed dosages are essential for minimizing complications and ensuring its benefits outweigh its risks.  

Frequently Asked Questions

Can I take Eliquis with other medications?

Eliquis can interact with several other medications, including over-the-counter pain medications, including ibuprofen and aspirin. Antibiotics, antifungal medications, and some antidepressants can also interact with Eliquis, potentially altering its effectiveness. 

Are there lifestyle changes I should make while taking Eliquis?

Yes, it’s essential to make some lifestyle changes while on Eliquis to reduce the risk of bleeding and other side effects. These include avoiding contact sports or activities that increase the risk of injury, utilizing a soft toothbrush to prevent gum bleeding, and shaving with an electric razor to avoid cuts. Additionally, patients should avoid excessive alcohol consumption, as alcohol can increase the risk of bleeding.

How can I reduce the risk of bleeding while on Eliquis?

To reduce the risk of bleeding, avoid using nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen unless directed by your healthcare provider. If you need pain relief, acetaminophen is generally safer. Maintaining good dental hygiene and making use of a soft toothbrush can help prevent gum bleeding, and it’s important to promptly report any signs of bleeding, including blood in the urine or stools, to your healthcare provider.

How often should I have check-ups while taking Eliquis?

Regular check-ups are essential while taking Eliquis, especially for elderly patients or those with other medical conditions. Your healthcare provider may advise blood tests to monitor your kidney and liver function and ensure that your blood is clotting correctly. These check-ups are crucial for catching any potential side effects early and adjusting your treatment as needed.