Eliquis Interactions: Alcohol, Medications, and Others

Eliquis is a prescription medication commonly used to prevent blood clots and strokes in patients with atrial fibrillation, deep vein thrombosis, and pulmonary embolism. While effective in its use, Eliquis also has interactions with various substances and medications which can potentially diminish its effectiveness, increase the risk of bleeding or other negative side effects.

One of the most significant Eliquis interactions to avoid is the consumption of alcohol. Drinking alcohol increases the risk of bleeding and can cause stomach ulcers or other gastrointestinal issues. Eliquis also interacts with specific medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), blood thinners, and corticosteroids, which increase the risk of bleeding and could affect Eliquis’s effectiveness.

Other substances that can interact with Eliquis include herbal supplements, vitamins, and over-the-counter medications. It is essential to consult with a healthcare provider and disclose all current medications and supplements before beginning Eliquis treatment.

Understanding the interactions of Eliquis with other substances and medications is crucial to prevent negative side effects and maximize the effectiveness of treatment. Always consult with a healthcare provider before beginning or adjusting your Eliquis treatment.

Risks of Combining Eliquis with Alcohol

Increased Risk of Bleeding

When Eliquis is taken with alcohol, it can increase the risk of bleeding. This is because both Eliquis and alcohol thin the blood, making it harder for clotting to occur. The combination of these two substances can increase the risk of bleeding in the body, which can lead to serious health complications.

Decreased Effectiveness of Eliquis

Drinking alcohol while taking Eliquis can also decrease its effectiveness. This is because alcohol can interfere with the metabolism of Eliquis in the liver, which can lead to lower levels of the drug in the bloodstream. This can make Eliquis less effective in preventing blood clots and stroke.

Other Risks

Combining Eliquis with alcohol can also increase the risk of other health complications, such as liver damage and impaired judgment. Both alcohol and Eliquis can be hard on the liver, and combining the two can put extra stress on this organ. Additionally, drinking alcohol while taking Eliquis can impair judgment and increase the risk of falls and accidents.

• It is important to avoid drinking alcohol while taking Eliquis.
• If you do drink alcohol, it is crucial to do so in moderation and under the guidance of a healthcare professional.
• It is also important to avoid taking any other medications or supplements without consulting a doctor, as they can interact with Eliquis and increase the risk of bleeding or other health complications.
• Speak with your doctor if you have any concerns about taking Eliquis or have a history of alcohol abuse or liver disease.

Medications that Interfere with Eliquis

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen can increase the risk of bleeding when taken with Eliquis. These drugs work by inhibiting the clotting process, which can increase the risk of bleeding when taken with anticoagulants.

Anticoagulants

Using Eliquis with other anticoagulants such as heparin, warfarin, and dabigatran can increase the risk of bleeding. Combining anticoagulants can lead to excessive thinning of the blood, increasing the risk of internal bleeding or hemorrhage.

Antiplatelet Drugs

Antiplatelet drugs such as clopidogrel and ticagrelor can also increase the risk of bleeding when taken with Eliquis. These drugs prevent platelets in the blood from forming clots, which can increase the risk of bleeding when combined with other anticoagulants or antiplatelet drugs.

St. John’s Wort

St. John’s Wort, a popular herbal supplement, can reduce the effectiveness of Eliquis by increasing the rate at which it is metabolized in the liver. This can decrease the amount of Eliquis in the bloodstream and reduce its anticoagulant effects.

Certain Antibiotics

Certain antibiotics such as rifampin and rifabutin can increase the metabolism of Eliquis, reducing its effectiveness in preventing blood clots. Patients taking Eliquis should inform their doctors if they are taking any antibiotics.

Summary

It is important to discuss all medications, supplements, and herbal remedies with a doctor before starting Eliquis to ensure there are no interactions that could reduce its effectiveness or increase the risk of bleeding.

Foods to Avoid When Taking Eliquis

Vitamin K-rich Foods

Eliquis works by preventing blood clots from forming. However, if you consume high amounts of Vitamin K-rich foods, it can counteract the effects of the medication and increase your risk of blood clots. Therefore, it is recommended to limit your intake of foods such as kale, spinach, collard greens, broccoli, brussels sprouts, and parsley.

Grapefruit and Grapefruit Juice

Grapefruit and grapefruit juice can interact with Eliquis and increase the amount of medication in your bloodstream. This can lead to harmful side effects such as bleeding. It is best to avoid consuming grapefruit or drinking grapefruit juice while taking Eliquis.

Alcohol

Alcohol can increase the risk of bleeding when taken with Eliquis. Therefore, it is best to limit or avoid alcohol consumption while taking this medication.

Green Tea

Green tea contains high levels of Vitamin K, which can interfere with the effects of Eliquis. It is recommended to limit your intake of green tea or avoid it altogether while taking this medication.

Fatty Foods

Fatty foods can affect the way your body absorbs Eliquis, which can make the medication less effective. Therefore, it is best to limit your intake of fatty foods while taking this medication.

Salt Substitutes

Some salt substitutes contain high levels of potassium, which can interact with Eliquis and increase the risk of bleeding. It is best to avoid salt substitutes while taking this medication.

Summary

When taking Eliquis, it is important to be aware of the foods and beverages that can interact with this medication and increase your risk of bleeding. Be sure to talk to your healthcare provider about any concerns or questions you may have about your diet while taking Eliquis.

Food/Beverage	Interactions with Eliquis
Vitamin K-rich Foods	Can counteract effects of medication
Grapefruit/Grapefruit Juice	Increases amount of medication in bloodstream
Alcohol	Increases risk of bleeding
Green Tea	Interferes with effects of medication
Fatty Foods	Makes medication less effective
Salt Substitutes	Increases risk of bleeding

Herbs and Supplements That Can Affect Eliquis

Ginkgo biloba

Ginkgo biloba is an herbal supplement that is commonly used for its cognitive benefits. However, it can also affect the way in which Eliquis is metabolized in the body. Studies have shown that ginkgo biloba can increase the risk of bleeding when taken with blood thinners such as Eliquis.

Garlic

Garlic is another herb that can affect the way that Eliquis is metabolized in the body. Garlic has blood-thinning properties, which means that it can increase the risk of bleeding when taken with Eliquis. It is important to avoid taking garlic supplements while taking Eliquis.

Vitamin K supplements

Vitamin K supplements can interfere with the effectiveness of Eliquis. Vitamin K is an essential nutrient that is necessary for blood clotting. However, when taken with Eliquis, it can decrease the effectiveness of the medication. It is important to avoid taking vitamin K supplements while taking Eliquis, unless you are directed to do so by your healthcare provider.

Fish oil supplements

Fish oil supplements are popular for their many health benefits, including their ability to reduce inflammation and improve heart health. However, fish oil supplements can also increase the risk of bleeding when taken with Eliquis. It is important to speak with your healthcare provider before taking fish oil supplements while taking Eliquis.

St. John’s Wort

St. John’s Wort is an herbal supplement that is used to treat depression and anxiety. However, it can also affect the way in which Eliquis is metabolized in the body. Studies have shown that St. John’s Wort can decrease the effectiveness of Eliquis, which can increase the risk of blood clots.

• It is important to speak with your healthcare provider before taking any herbs or supplements while taking Eliquis.
• Make sure to inform your healthcare provider of all herbs and supplements that you are taking.
• Do not stop taking prescribed medications without first consulting your healthcare provider.

Eliquis Interactions with Over-the-Counter Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Commonly used over-the-counter pain relievers such as aspirin, ibuprofen, and naproxen can increase the risk of bleeding when taken with Eliquis. The combination of these NSAIDs with Eliquis can cause stomach ulcers, stomach bleeding, and other gastrointestinal issues. Be sure to talk to your doctor before taking any NSAIDs while on Eliquis.

Herbal Supplements

Herbal supplements such as Ginkgo biloba, ginger, and garlic can increase the risk of bleeding when taken with Eliquis. These supplements can also interfere with the effectiveness of the medication. Some supplements may also interact with other medications you are taking. Always talk to your doctor before taking any herbal supplements while on Eliquis.

Cold and Flu Medications

Cold and flu medications such as aspirin, acetaminophen, and cough suppressants can increase the risk of bleeding when taken with Eliquis. These medications can also interfere with the effectiveness of the medication. Always talk to your doctor before taking any cold or flu medications while on Eliquis.

St. John’s Wort

St. John’s Wort is an herbal supplement commonly used to treat depression. However, it can also interact with Eliquis and make it less effective. If you take St. John’s Wort, talk to your doctor before taking Eliquis.

Conclusion

Over-the-counter medications may seem harmless, but they can interact with Eliquis and increase the risk of bleeding. Always talk to your doctor before taking any over-the-counter medications, including pain relievers, herbal supplements, and cold and flu medications.

Warnings for Patients with Kidney or Liver Problems

Kidney Problems

If you have kidney problems, you should be aware that the medication Eliquis is primarily eliminated from the body through the kidneys. Therefore, patients with severe kidney problems may be at a higher risk for bleeding events when taking Eliquis. Additionally, the dose of Eliquis may need to be adjusted if you have kidney problems.

• Inform your doctor if you have any kidney problems before starting Eliquis treatment.
• Your doctor may perform regular blood tests to monitor your kidney function while taking Eliquis.
• If you experience any unusual bleeding or bruising, contact your doctor immediately.

Liver Problems

If you have liver problems, the medication Eliquis may not be suitable for you. The liver plays a significant role in processing Eliquis, and patients with severe liver problems may experience a higher concentration of the medication in their bodies. This can increase the risk of bleeding events and other side effects.

• Inform your doctor if you have any liver problems before starting Eliquis treatment.
• Your doctor may perform regular blood tests to monitor your liver function while taking Eliquis.
• If you experience any signs of liver problems such as yellowing of the eyes or skin, dark urine, abdominal pain, or loss of appetite, contact your doctor immediately.

Interactions of Eliquis with Blood Thinners and Anti-Coagulants

Interaction with Warfarin

Eliquis should not be taken with warfarin because it can increase the risk of bleeding. Warfarin is a blood thinner that is used to prevent blood clots. If taken with Eliquis, it can cause the blood to thin too much, leading to bleeding complications. If warfarin needs to be discontinued, a doctor should monitor blood clotting levels closely to avoid potential bleeding risks.

Interaction with Heparin

Eliquis may also interact with heparin, another anti-coagulant used to prevent blood clots. Use of the two drugs together may increase the risk of bleeding. Although it is possible for heparin to be used in combination with Eliquis, a doctor must carefully monitor the dosage and duration of treatment to prevent excessive bleeding.

Interaction with Plavix

Plavix is a medication used to prevent the formation of blood clots. While it is not a blood thinner, it does have anti-coagulant effects. When taken with Eliquis, the risks of bleeding may increase. Patients using both medications together must be closely monitored by their doctor to prevent excessive blood thinning and bleeding complications.

Interaction with Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are commonly used as pain relievers and anti-inflammatory medications. Examples of NSAIDs include aspirin, ibuprofen, and naproxen. When used with Eliquis, they may increase the risk of bleeding. Patients must consult with their doctor before using NSAIDs while taking Eliquis.

Interaction with Herbal Supplements

Herbal supplements such as garlic, ginger, ginkgo, and ginseng can also increase the risk of bleeding when taken in combination with Eliquis. Patients should discuss any herbal supplements they are taking with their healthcare provider to avoid potential side effects or interactions.

Conclusion

Patients taking Eliquis should inform their doctor of all medications, supplements, and herbal remedies they are taking to avoid any interactions that may increase the risk of bleeding. Regular blood tests and medical check-ups are also important to ensure safe and effective use of Eliquis.

Contraindications for Eliquis Use with Some Medical Conditions

Stroke or Severe Brain Injury

Patients with a history of stroke or severe brain injury should avoid using Eliquis as it may increase the risk of bleeding in the brain. If Eliquis is necessary for the patient’s condition, close monitoring and adjustment of the dosage may be required.

Active Bleeding or Bleeding Disorders

Patients with an active bleeding or bleeding disorders, such as hemophilia, should not use Eliquis. Eliquis increases the risk of bleeding and can worsen bleeding disorders. Consult a healthcare provider for alternative treatment options.

Hepatic Impairment

Eliquis is metabolized by the liver, so patients with hepatic impairment should use caution when taking this medication. Close monitoring of liver function and adjustment of the dose may be necessary to avoid harmful side effects.

Pregnancy and Breastfeeding

The safety of Eliquis in pregnant and breastfeeding women is not established, so it should be used only if the benefits outweigh the risks. Consult a healthcare provider before taking Eliquis in these circumstances.

Effects of Eliquis with Grapefruit and Grapefruit Juice

Grapefruit and Eliquis

Grapefruit and grapefruit juice can affect the way Eliquis works in the body. Grapefruit inhibits the activity of the enzyme CYP3A4, which is responsible for breaking down Eliquis. When this enzyme is inhibited, the levels of Eliquis in the blood can increase, leading to an increased risk of side effects or bleeding.

How to Avoid Interactions

To avoid interactions between Eliquis and grapefruit or grapefruit juice, it is recommended to avoid consuming these products while taking Eliquis. If you do consume grapefruit products, you should speak to your doctor about adjusting your Eliquis dose or switching to an alternative medication.

Other Interactions to Consider

It is important to note that grapefruit is not the only food or beverage that can interact with Eliquis. Other foods that can affect the activity of CYP3A4 include oranges, limes, and pomelos. Additionally, some medications, such as antibiotics and antifungal medications, can also interact with Eliquis. It is crucial to speak with your physician or pharmacist about any potential drug interactions before starting treatment with Eliquis.

Eliquis Interactions with Antibiotics and Antifungal Drugs

Antibiotics

Eliquis may interact with antibiotics that convert to and inhibit CYP3A4 and P-gp, enzymes that metabolize and transport Eliquis, respectively. Antibiotics such as clarithromycin, erythromycin, and telithromycin may increase the levels of Eliquis in your blood and increase the risk of bleeding. Therefore, you should tell your doctor if you are taking any antibiotics before starting Eliquis treatment.

Antifungal Drugs

Eliquis may also interact with antifungal drugs that inhibit CYP3A4 and P-gp. Antifungal drugs such as ketoconazole, itraconazole, and voriconazole can enhance the effects of Eliquis by increasing its concentration in your blood. This can cause bleeding. Therefore, you should inform your doctor if you are taking any antifungal drugs before starting Eliquis.

It’s important to note that these interactions are not comprehensive, and other antibiotics and antifungal drugs may also interact with Eliquis. Therefore, before starting on any new medication, you should consult with your doctor or pharmacist to ensure that it is safe to take with Eliquis.

You should also inform your healthcare provider if you experience any unusual bleeding or bruising or other side effects while taking Eliquis and any other medications together.

• In conclusion, it is important to talk to your healthcare provider about possible interactions of Eliquis with antibiotics and antifungal drugs. Your doctor can adjust your Eliquis dosage, monitor your blood tests, or recommend other medications if needed.