Key takeaways:
Eliquis (apixaban) is a blood thinner that treats and prevents unwanted blood clots. The most common Eliquis side effect is mild bleeding. Nausea and anemia are also possible.
Serious Eliquis side effects include severe bleeding and dizziness or confusion. And you’re at risk for blood clots if you stop taking Eliquis sooner than recommended.
Let your prescriber know about mild bleeding, such as nosebleeds or light bruising. But seek emergency care for bleeding that doesn’t stop or blood in your urine or stool.
Eliquis (apixaban) is an anticoagulant (blood thinner) that treats and prevents unwanted blood clots. It belongs to a group of medications called direct-acting oral anticoagulants (DOACs). Unlike the older anticoagulant warfarin (Coumadin, Jantoven), DOACs don’t require frequent blood tests. These days, they’re often a first-choice medication for preventing blood clots. That’s because Eliquis and other DOACs have a lower risk of bleeding events compared to warfarin.
But keep in mind that a lower risk isn’t the same as no risk at all. As with all blood thinners, Eliquis has some side effects, including a risk of bleeding.
Eliquis side effects at a glance
Below are the mild and serious Eliquis side effects reported by people taking it. Keep in mind that you may experience side effects that aren’t listed here. So it’s best to check in with a healthcare professional about any side effects you notice while taking Eliquis.
Mild Eliquis side effects include:
Minor bleeding
Nausea
Constipation
Anemia (low red blood cells)
Rare but potentially serious Eliquis side effects include:
Fainting
Serious bleeding events
Bleeding-related complications
Increased liver enzymes
Allergic skin reactions (may appear weeks after starting Eliquis)
Eliquis also has two boxed warnings, the FDA’s strictest warning for medications. While rare, these side effects can be life-threatening:
Increased risk of a spinal bleed during certain spinal procedures
Increased risk of blood clots if you stop taking Eliquis earlier than recommended
Let’s look at seven Eliquis side effects in more detail, including how to manage them and when to seek medical care.
1. Minor bleeding and bruising
Minor bleeding is one of the most common side effects of taking Eliquis. Minor bleeding includes:
Light bruising
Bleeding from the gums when brushing your teeth
Heavier or longer menstrual periods
The amount of blood loss or bruising should be small to be considered a minor bleed. And bleeding usually stops on its own.
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Minor bleeding isn’t usually a serious health concern. But it’s best to let your prescriber know if you have any signs of bleeding while taking Eliquis. They may run some tests to make sure there’s not a more serious issue going on.
2. Serious bleeding
It’s also possible for Eliquis to cause severe bleeding. The likelihood of a serious bleeding event while taking Eliquis is low (3% or less in studies). But it can be life-threatening if it isn’t treated right away.
To prevent serious bleeding, your prescriber will review your health regularly. They’ll help you assess the risks and benefits of taking Eliquis. And they’ll make sure it’s working well for you without any major side effects. So make sure to keep your scheduled appointments. And don’t stop taking Eliquis at any time unless your prescriber tells you to.
If you do have a severe bleed, it’s best to treat it as soon as possible. Keep an eye out for signs and symptoms of a serious bleeding event. This includes:
Bleeding that doesn’t stop
Bruising that happens without a known cause or that covers a large area of your body
Heavy menstrual bleeding (soaking through protection within an hour for several hours in a row)
Blood in your urine
Bright red blood in your stool
Melena (black, tarry stool)
Coughing up blood
Vomiting blood (may look like coffee grounds)
Confusion, vision changes, or headaches (may be symptoms of bleeding in the brain)
Seek medical attention immediately if you experience any of these symptoms. There are treatments available to help reverse life-threatening bleeding events (such as Andexxa). These treatments are given in a hospital setting.
3. Nausea
Nausea is possible while taking Eliquis. However, it’s not all that common. Nausea was reported in around 3% of people taking Eliquis in clinical trials.
Dealing with nausea can make you uncomfortable and impact your quality of life. If it happens, try taking Eliquis with a small snack or meal to help. And be sure you’re staying hydrated, too.
If your nausea is severe or you’re vomiting after taking Eliquis, talk to your prescriber. You may need a different blood thinner that’s easier on your stomach.
Good to know: Nausea can also be a sign of internal bleeding. So keep an eye out for any other bleeding-related symptoms, such as stomach pain or blood in your stool.
4. Dizziness or confusion
It’s not common, but there are reports of dizziness and confusion while taking Eliquis. These side effects seem to be more likely in older adults, but we don’t know for sure why they happen. If you feel dizzy, lightheaded, or you’re unable to think clearly while taking Eliquis, talk to your prescriber. They can help determine the cause and change you to a different blood thinner if needed.
Good to know: Similar to nausea, dizziness and confusion can also be signs of bleeding. Specifically, they can happen if you have bleeding in your brain. So if these symptoms appear suddenly, or appear along with a headache or other signs of bleeding, seek emergency medical care right away.
5. Anemia
Anemia (a low amount of red blood cells) is another possible Eliquis side effect. Anemia can be caused by low iron or vitamin B12 levels. It’s also common in older adults and those with heart conditions.
Eliquis may contribute to anemia by raising your bleeding risk. When you bleed, you lose red blood cells. So if your red blood cell levels are low, it could be a sign that there’s bleeding happening somewhere in your body.
Symptoms of anemia include dizziness, fatigue, and a fast heartbeat. You may also have leg cramps and cravings to chew ice. Your skin may seem paler than usual, and over time you may notice brittle nails and hair loss.
Let your prescriber know if you have any signs and symptoms of anemia. They’ll be able to check your red blood cell count to see if it’s lower than usual and decide on the best course of action.
6. Spinal bleeding
Eliquis makes it more likely to develop bleeding in your spine during certain spinal procedures. This includes a spinal puncture (spinal tap) or epidural. Bleeding in the spine can lead to serious consequences, such as long-term paralysis. As mentioned, Eliquis carries a boxed warning about this risk.
To avoid this side effect, your healthcare team may have you stop taking Eliquis before you have a spinal procedure. Eliquis is typically stopped a day or two before any surgery. And it’s often started again a day or two after surgery. This exact plan will depend on your medical situation. Be sure to clarify instructions with your healthcare team if you have any questions.
If you develop back pain with tingling, numbness, or weakness, seek medical care right away — especially if it happens after a spinal procedure. This could be a sign of bleeding in your spine.
7. Blood clots
Eliquis treats and prevents unwanted blood clots. But if you stop taking Eliquis sooner than recommended, your risk for blood clots goes up. Blood clots are dangerous because they can lead to life-threatening events such as a heart attack or stroke.
When you stop taking Eliquis will depend on what you’re taking it for. Generally, you’ll take Eliquis for at least 6 months. But some people may only take it for a short time. And for others, it’s a lifelong treatment. Your prescriber will base your Eliquis treatment on your personal medical history. So be sure to follow their recommendation, and don’t stop taking Eliquis sooner than directed.
It’s also helpful to be aware of the signs and symptoms of a blood clot:
Swelling, pain, or redness in an arm or leg
Difficulty breathing
Fast or irregular heartbeat
Coughing up blood
Chest pain
Low blood pressure
Seek medical attention if you have any of these symptoms. Treating a blood clot quickly can help prevent more serious problems, such as a stroke or heart attack.
Frequently asked questions
No, weight gain doesn’t seem to be an Eliquis side effect. But keep in mind that it’s often prescribed after a serious health event. So it’s possible that you may not be as active as you were before you started taking it. Emotional eating can also become an issue. And both of these may lead to weight gain. Focusing on a healthy exercise and eating plan can help you stay on track and keep weight changes to a minimum.
It might, but it isn’t common. A few cases of hair loss have been reported with Eliquis. But the risk doesn’t seem to be as high as with other anticoagulants, such as heparin and warfarin. If you’re losing hair while taking Eliquis, let your prescriber know. Hair loss can also be a symptom of anemia. So your prescriber may want to check your iron levels and your red blood cell count to see if that’s a possible issue.
It isn’t likely. Diarrhea wasn’t a reported side effect in clinical trials. A small number of people reported constipation in one study, but that doesn’t seem to be a common side effect either. If you experience diarrhea while taking Eliquis, there’s likely a different cause. But since everyone responds to medication differently, it’s still a good idea to talk to your prescriber for guidance.
Hypotension (low blood pressure) isn’t a common Eliquis side effect. A small number of people taking Eliquis after hip or knee replacement surgery experienced low blood pressure. But it isn’t clear if this was related to the surgery or to Eliquis itself. Severe bleeding can also lower your blood pressure. So if you experience a drop in blood pressure or feel dizzy or woozy while taking Eliquis, it's best to seek emergency care.
No, weight gain doesn’t seem to be an Eliquis side effect. But keep in mind that it’s often prescribed after a serious health event. So it’s possible that you may not be as active as you were before you started taking it. Emotional eating can also become an issue. And both of these may lead to weight gain. Focusing on a healthy exercise and eating plan can help you stay on track and keep weight changes to a minimum.
It might, but it isn’t common. A few cases of hair loss have been reported with Eliquis. But the risk doesn’t seem to be as high as with other anticoagulants, such as heparin and warfarin. If you’re losing hair while taking Eliquis, let your prescriber know. Hair loss can also be a symptom of anemia. So your prescriber may want to check your iron levels and your red blood cell count to see if that’s a possible issue.
It isn’t likely. Diarrhea wasn’t a reported side effect in clinical trials. A small number of people reported constipation in one study, but that doesn’t seem to be a common side effect either. If you experience diarrhea while taking Eliquis, there’s likely a different cause. But since everyone responds to medication differently, it’s still a good idea to talk to your prescriber for guidance.
Hypotension (low blood pressure) isn’t a common Eliquis side effect. A small number of people taking Eliquis after hip or knee replacement surgery experienced low blood pressure. But it isn’t clear if this was related to the surgery or to Eliquis itself. Severe bleeding can also lower your blood pressure. So if you experience a drop in blood pressure or feel dizzy or woozy while taking Eliquis, it's best to seek emergency care.
The bottom line
Eliquis (apixaban) is a prescription blood thinner. The most common side effect is mild bleeding. Nausea and anemia may also be an issue for some people.
Serious Eliquis side effects include severe bleeding and dizziness or confusion. And blood clots can happen if you stop taking Eliquis sooner than recommended. You may have to stop Eliquis for a medical test or procedure to prevent bleeding issues. Make sure to clarify instructions with your prescriber. And don’t stop taking Eliquis without talking to them first.
Let your prescriber know if you have signs of minor bleeding, such as nosebleeds or light bruising, while taking Eliquis. If you have bleeding that doesn’t stop or notice blood in your urine or stool, seek emergency care.
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