Eliquis, like many medications, can interact with other substances, potentially affecting its efficacy and safety. These interactions can occur with other prescription drugs, over-the-counter medications, supplements, and even certain foods. Understanding these potential interactions is crucial for patients taking Eliquis to ensure they receive the maximum benefit from their medication while minimizing risks.
Different types of interactions can lead to various outcomes. Some interactions might reduce the effectiveness of Eliquis, while others could amplify its effects, increasing the risk of side effects, particularly bleeding.
For more detailed information, you can also consult this resource on Eliquis drug interactions: Eliquis Drug Interactions.
Potential Drug Interactions with Eliquis
The following sections outline medications that are known to interact with Eliquis. It is important to note that this is not an exhaustive list, and other drugs may also interact with Eliquis.
Before starting Eliquis, it is essential to have an open conversation with your doctor and pharmacist. Provide them with a complete list of all medications you are currently taking, including prescription drugs, over-the-counter medicines, and any herbal supplements or vitamins. This information will help your healthcare providers assess potential interaction risks and make informed decisions about your treatment plan.
If you have any concerns or questions about potential drug interactions, always consult your doctor or pharmacist for personalized advice.
Eliquis and Antiplatelet Medications, Including Aspirin
Combining Eliquis with antiplatelet drugs significantly elevates the risk of bleeding. Unless specifically advised by your doctor, concurrent use of Eliquis and antiplatelet medications should be avoided. Antiplatelets, such as aspirin, clopidogrel (Plavix), and ticagrelor (Brilinta), are designed to prevent blood clots through a mechanism different from Eliquis.
Eliquis functions as an anticoagulant by targeting and inhibiting activated factor Xa, a crucial protein in the blood clotting cascade produced by the liver. By blocking factor Xa, Eliquis reduces the blood’s ability to clot. Antiplatelet drugs, conversely, prevent clot formation by interfering with platelet aggregation, the initial step in blood clot development.
If you are currently taking an antiplatelet drug, it is imperative to discuss with your doctor whether you should continue it when starting Eliquis. If your doctor deems the combination necessary, be vigilant for any signs of bleeding and seek immediate medical attention if bleeding occurs. For further details on bleeding risks, refer to the “Eliquis side effects” section.
Eliquis and Other Anticoagulants
Eliquis itself is an anticoagulant, commonly known as a blood thinner, prescribed to prevent blood clots. Using Eliquis in conjunction with other anticoagulants dramatically increases the risk of bleeding.
Generally, taking Eliquis with another anticoagulant is contraindicated unless you are specifically transitioning from one anticoagulant to Eliquis. If you are switching from another anticoagulant, it is crucial to consult your doctor for detailed instructions on how to safely manage the transition.
Examples of other anticoagulant drugs include:
- rivaroxaban (Xarelto)
- dabigatran (Pradaxa)
- edoxaban (Savaysa)
- fondaparinux (Arixtra)
- dalteparin (Fragmin)
- enoxaparin (Lovenox)
- warfarin (Jantoven)
- heparin
Eliquis and Ibuprofen or Other Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are commonly used to alleviate pain, reduce swelling, and lower fever. However, NSAIDs also possess blood-thinning properties. When taken with Eliquis, NSAIDs can significantly increase the risk of bleeding. Therefore, avoid taking ibuprofen or other NSAIDs while on Eliquis treatment unless explicitly recommended by your doctor.
NSAIDs to avoid while taking Eliquis include:
- naproxen (Aleve)
- diclofenac (Voltaren, Zipsor)
- meloxicam (Mobic)
Be aware that some over-the-counter cold and flu remedies may contain ibuprofen or naproxen. Consult your doctor or pharmacist to identify cold and flu medications that are safe to use with Eliquis.
If you require pain relief or need to start any new medication during your Eliquis therapy, always discuss it with your doctor or pharmacist first.
Eliquis and Tylenol (Acetaminophen)
Tylenol, containing acetaminophen, is a pain reliever and fever reducer. Unlike NSAIDs, Tylenol does not interact with Eliquis and is considered safe to use for pain or fever management while taking Eliquis.
Eliquis and Certain Antidepressants
Certain antidepressants can increase the risk of bleeding when taken with Eliquis. These antidepressants primarily include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), which can affect platelet function and increase bleeding risk, particularly when combined with anticoagulants.
Examples of such antidepressants include:
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac, Sarafem)
- paroxetine (Paxil, Pexeva)
- sertraline (Zoloft)
- venlafaxine (Effexor XR)
- desvenlafaxine (Pristiq, Khedezla)
- duloxetine (Cymbalta)
If you need to take any of these antidepressants with Eliquis, discuss the safety of this combination with your doctor. They might suggest an alternative antidepressant with a lower bleeding risk. If concurrent use is necessary, monitor closely for any signs of bleeding and promptly report them to your doctor. Refer to the “Eliquis side effects” section for details on bleeding symptoms.
Eliquis and Certain Antifungal Drugs
Certain antifungal medications can elevate the levels of Eliquis in your body, potentially increasing the risk of bleeding. These antifungals primarily inhibit CYP3A4, an enzyme in the liver responsible for breaking down Eliquis. By inhibiting this enzyme, these antifungals can slow down Eliquis metabolism, leading to higher drug concentrations.
Examples of antifungals that can increase Eliquis levels include:
- itraconazole (Sporanox, Tolsura)
- ketoconazole
If you require treatment with these antifungal drugs while taking Eliquis, your doctor may adjust your Eliquis dosage to mitigate the increased bleeding risk. If dosage adjustment is not feasible, your doctor may explore alternative treatment options.
Eliquis and Certain HIV Drugs
Similar to certain antifungals, some HIV medications can also increase Eliquis levels in the body by inhibiting CYP3A4. This can lead to a heightened risk of bleeding.
Examples of HIV drugs that can increase Eliquis levels include:
- cobicistat (Tybost)
- ritonavir (Norvir)
If you need to take these HIV drugs with Eliquis, your doctor might prescribe a reduced dose of Eliquis. If dose reduction is not suitable, alternative treatment strategies will be considered.
Eliquis and Rifampin
Rifampin (Rifadin), an antibiotic used to treat bacterial infections like tuberculosis, can decrease the levels of Eliquis in your body. Rifampin is a CYP3A4 inducer, meaning it increases the activity of this enzyme. This can lead to faster metabolism and elimination of Eliquis, reducing its effectiveness in preventing blood clots.
Concurrent use of rifampin and Eliquis should generally be avoided. If rifampin treatment is necessary, discuss safe alternatives with your doctor to maintain effective anticoagulation.
Eliquis and Certain Seizure Medications
Certain seizure medications can also reduce Eliquis levels in the body, similar to rifampin. These drugs are also CYP3A4 inducers and can accelerate Eliquis metabolism, potentially making it less effective in preventing blood clots.
Examples of seizure medications that can reduce Eliquis effectiveness include:
- carbamazepine (Carbatrol, Equetro, Tegretol)
- fosphenytoin (Cerebyx)
- phenobarbital
- phenytoin (Dilantin, Phenytek)
- primidone (Mysoline)
These seizure medications should generally be avoided in patients taking Eliquis. If you require seizure management, discuss safer treatment options with your doctor to ensure both seizure control and effective anticoagulation.
Eliquis and Antacids
Most antacids themselves do not interact with Eliquis. However, some over-the-counter antacids contain aspirin, an antiplatelet drug. As previously discussed, combining Eliquis with antiplatelet drugs increases bleeding risk.
Alka-Seltzer is an example of an antacid that may contain aspirin.
When choosing an antacid, carefully check the ingredient list for aspirin. If you have any questions or concerns, consult your doctor or pharmacist.
Herbs and Supplements Interactions with Eliquis
The following information addresses potential interactions between Eliquis and certain herbs and supplements.
Eliquis and St. John’s Wort
St. John’s wort, a herbal supplement often used for mood disorders, can lower Eliquis levels in the body, potentially reducing its effectiveness. St. John’s Wort is another CYP3A4 inducer and can increase Eliquis metabolism.
Avoid using St. John’s wort while taking Eliquis to ensure consistent and effective anticoagulation.
Eliquis and Turmeric
The interaction between turmeric and Eliquis is not fully understood. Turmeric contains curcumin, a compound known for its anti-inflammatory properties. While some anti-inflammatory medications like ibuprofen should be avoided with Eliquis, the specific interaction with turmeric is less clear.
Some research suggests that turmeric might affect how Eliquis is metabolized, potentially leading to increased Eliquis levels and a higher bleeding risk. However, the clinical significance of this potential interaction is not well-established.
If you are considering using turmeric or curcumin supplements while taking Eliquis, consult your doctor first to discuss potential risks and benefits.
Eliquis and Melatonin
Melatonin, a hormone supplement often used for sleep, may possess mild blood-thinning properties. While no studies have definitively confirmed an interaction between melatonin and Eliquis, there is a theoretical risk that combining them could increase the risk of bleeding.
If you wish to use melatonin while taking Eliquis, it is advisable to consult your doctor to assess the potential risks and benefits based on your individual health profile.
Eliquis and Vitamin K
Vitamin K does not affect the way Eliquis works in the body. Unlike warfarin, another anticoagulant whose effectiveness is influenced by vitamin K intake, Eliquis’s anticoagulant action is independent of vitamin K.
Therefore, dietary vitamin K intake does not need to be restricted or specifically monitored while taking Eliquis.
Eliquis and Fish Oil
Fish oil, in most cases, does not directly interact with Eliquis. However, fish oil supplements, particularly at high doses, can have mild blood-thinning effects. Taking Eliquis with high doses of fish oil might potentially increase the risk of bleeding.
If you are taking fish oil supplements or considering starting them while on Eliquis, discuss this with your doctor or pharmacist to assess your individual bleeding risk.
Food Interactions with Eliquis
Eliquis can interact with certain foods, and it is important to be aware of these potential interactions.
Eliquis and Grapefruit
Grapefruit and grapefruit juice can interact with Eliquis. It is recommended to avoid consuming grapefruit or grapefruit juice while taking Eliquis.
Grapefruit inhibits CYP3A4, the same liver enzyme that breaks down Eliquis. By blocking this enzyme, grapefruit can slow down Eliquis metabolism, leading to elevated drug levels in the body and an increased risk of side effects, particularly bleeding.
If you have any questions about grapefruit consumption during your Eliquis treatment, consult your doctor.
Eliquis and Coffee (Caffeine)
Coffee and other caffeinated beverages do not affect how Eliquis works in the body. While caffeine can interact with warfarin in some cases, this is not the case with Eliquis.
There is no need to avoid coffee or other caffeinated foods or drinks while taking Eliquis.
Eliquis and Green Leafy Vegetables
Green leafy vegetables, rich in vitamin K, do not interfere with Eliquis’s mechanism of action. While vitamin K can affect warfarin, it does not impact Eliquis.
Therefore, you do not need to limit or avoid green leafy vegetables in your diet while taking Eliquis.
Eliquis and Surgery
Surgery inherently carries a risk of bleeding, and this risk is amplified in patients taking Eliquis. If you have a scheduled surgery, your doctor will typically advise you to stop taking Eliquis a few days prior to the procedure to minimize bleeding risks during and after surgery.
Always inform your doctor about any planned surgeries so they can provide specific instructions on when to stop and restart Eliquis. Do not stop taking Eliquis without consulting your doctor.
Discuss with your doctor when it is safe to resume Eliquis after surgery. You may be prescribed an alternative blood clot prevention strategy during the period you are off Eliquis.
In case of emergency surgery while you are taking Eliquis, you may receive an antidote to Eliquis to reverse its anticoagulant effects and reduce bleeding risk. For more information about reversing Eliquis effects, refer to the “Reversing Eliquis bleeds” section.
This information is intended to provide a comprehensive overview of potential Eliquis interactions. It is not a substitute for professional medical advice. Always consult your doctor or pharmacist for personalized guidance regarding Eliquis and its potential interactions with other substances. Proper diagnosis and management of Eliquis therapy are crucial for your health and safety.
