Q. I have been taking Coumadin (warfarin) for years, however, my doctor recently recommended that I switch to Xarelto or Eliquis. I am looking for more information on Eliquis to evaluate the pros and cons. Your help will be greatly appreciated.

A. We have consulted a cardiologist at the Cleveland Clinic who deals with atrial fibrillation (AFib) on a regular basis. He is cautious about the new medications because he says it is hard to assess their effectiveness in any given patient.

Unlike with warfarin, there is no easy blood test to tell when you have achieved the optimal blood thinning effect. He also pointed out that it is hard to reverse the anticoagulant effect. There is no “antidote” to an overdose that might lead to hemorrhage.

Many patients may do quite well on Eliquis, but we would hope that a knowledgeable cardiologist would be involved in such a decision and provide adequate oversight. The drug should never be stopped suddenly.


  • The most serious complication is bleeding. Patients can bruise or bleed more easily when on this drug. Notify your doctor promptly if this occurs. Dark or tarry stools would be a possible warning sign of digestive tract bleeding. If you throw up and detect blood or anything that looks vaguely like coffee grounds, that would be a sign that there might be bleeding in the stomach.
  • Let your doctor know if your gums bleed after brushing or flossing your teeth or if you experience nosebleeds or pink, red or brown urine. A bad headache or a feeling of dizziness should also be discussed immediately as these could be signs of bleeding in the brain.
  • Swelling of the joints or joint pain could signal bleeding in that area. Report such a side effect promptly to the prescriber
  • Skin Rash could signal a serious allergic reaction. Report such a symptom immediately. Swelling of tongue or face or trouble breathing also requires emergency treatment.


Do not take any other drugs without checking first with your prescriber.

  • Aspirin (may increase the risk of bleeding while taking Eliquis)
  • NSAIDs (all anti-inflammatory drugs including ibuprofen, naproxen, diclofenac, etc) could increase the risk of bleeding)
  • Other anticoagulants such as clopidogrel or warfarin may increase bleeding risk when combined with Eliquis
  • Antiseizure drugs such as carbamazepine and phenytoin may reduce the effective of Eliquis. St. John’s wort may also have this effect.
  • Antifungal medications (ketoconazole and itraconazole) may increase the risk of toxicity and bleeding. Dosage modifications are essential.
  • Antibiotics such as clarithromycin may also increase the risk of side effects associated with Eliquis.

Bottom line: be vigilant for signs of bleeding and always check about drug interactions before adding an herb, an OTC drug or another prescription medication to Eliquis.


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  1. Frances Smith
    Kansas City, Kansas

    I have been on eliquis since June 2015. recently I have experienced painful arm pain interrupting my sleep at night. Also I am on Hctz and lisenipril . I do not know if these meds will affect the eliquis that I am on. Also I have had abdominal pain. By accident they drew blood for an INR and found my blood was a little thin. The blood clot was found in my arm after I had a pacemaker put in. I am also on Lipitor. I do not know if I can contribute muscle pain to this. I will consult with my doctor next week to find out if I need to switch to another med.. and will they give me a sonogram to find out the progression of the clot.

  2. Sharon

    Hi I had my second PE in March 2016 and have been put on Eliquis for life. Since starting I am experiencing severe swelling and joint pain of all my fingers and my neck. I am going to see a rheumatologist this week to see if it’s some sort of arthritis however this has only come on since I started Eliquis. I am beside myself with worry as I feel each day my hands are getting weaker, more painful and stiff. I am not sleeping due to the pain therefore very emotional all the time. I just want to get my life back. Anybody else had these experiences??? I am 52 years old and very active however this is turning me into an old lady that doesn’t want to even go out. Please help me if you can!!!!

  3. Carol
    Geneva, fl

    Talking Eloqist now since 4/2/2016 for a deep vein dat and pulmonary embolism. The pe was treated with tpa via a catheter in the clot for 24 hours. They were concerned about trying to capture the left leg clot. A ivc filter was placed to capture any rogue clots. Since being on Eloquist, my restless legs at night have progressed to leg jerking and cramping. I usually only had rls at night, but now it is all day. My abdomin has very listened , bloated and hard( not gas), and experiencing right and left groin pain. Horrible groin pains. My doctor wanted to change the anticoagulant to Carleton, but after reading about it, there was no way I was taking that. No counter agent and bleed more easily. I M a klutz. I had difficulty keeping my inr normal with Coumadin in the past for a dat in the same spot. I am wondering if I should bite the bullet, with weekly blood tests , special diet etc all and change to Coumadin. The things I feel now, along with the fatigue are not worth it, and since I have to be on blood thinners for the rest of my life, I don’t want to feel like crap forever. No fun. Plus the side effects make me think other things are happening, when they are not.

  4. Bronte

    Having A-fib is definitely not better than possible side effects. Unless you’re fine with having a stroke

  5. Preston

    I’ve experienced nosebleed. .no energy..headaches. ..shortness of breath since being on eloquis for the last month due to unexplained blood clot in left leg . should i be concerned?

  6. Willow

    I have had a mixed bag with eliquis so far. I have been on eliquis for 5 months (I had a stroke in late August). I have noticed heavy menstrual bleeding, and acne everywhere, not just on my face but on my back, stomach, upper and lower arms, shoulders, calves, butt, EVERYWHERE. And it doesn’t respond to treatment. I never had this bad of acne even when I was in puberty. I feel nauseated randomly, and recently when I got the stomach flu I was really lightheaded so my husband rushed me to the er in case it was internal bleeding… All in all, its been better than coumadin, but worse than not taking anything at all.

    • Willow

      I’m in my 20s, by the way.

  7. Diane
    Raleigh Nc

    I’ve been on Eliquis since Nov. I’ve had A-fib for yrs. 30+. This time my cardiologist at Duke Univ put me on a monitor and he said I was in Presistent A-Fib.
    He put me on Eliquis. Upped my heart med. so I’m on three heart Meds now.
    To say the least I’m petrified. He choose Eliquis over o e of the older ones. He said no Bld testing. No worry about food with Vit K.

    What scares me is that this Eliquis is new. So was the ones you hear people are entitled to sue over for side effects. Plus they say you can’t get off of Eliquis.

    I’m supposed to have both knees replaced. Cataracts removed, dental work. I’m frightened to death.
    Does anyone have any encouragement or beg thoughts. I would appreciate hearing. Thanks

    • Carol

      It seems that you are maybe having too many meds.Perhaps you could cut down on them

      • Shelly

        I believe people should Never, ever, ever stop taking Eliquis until they are on another blood thinner And have an INR Blood Test that says they are at a safe INR level for an Atrial Fibrillation patient.
        My mother quit taking Eliquis gradually over a two week period due to an allergic type reaction and had strokes in Four areas of her brain.
        I think they are going to find that the percentage for rebound strokes is much, much, higher than ever expected.

    • Sara

      Whoever said you “can’t” get off Eliquis is wrong.. You can always try one of the others….

  8. Jack
    Oceanside, CA

    There must be reasons for those law suits.

  9. Peggy

    Not to mention the cost of this drug! Even with insurance it is costing a fortune. I am on Medicare with Blue Cross supplemental and a drug plan. But in January it will cost me $335, and the cost of the drug will put me in the “donut hole” in August!

  10. Brenda

    Gone to see a hemo . tomorrow! I devoped PE and small knee surgery they put me on Eliquis! On 9/18/15
    I get headaches on and off , a lot of boating plus crimping and indigestion ! So scary, I hope I can get off this stuff but not sure because of family history of DVT! Any comments I would be grateful !

  11. Loretta

    After a second incidence of DVT, I was put on Pradaxa. Took it for 6 months with few problems but started to feel a lot of pain in my lower back and in each hipbone as well as my wrist/thumb. I stopped taking it (AMA) and started feeling better within 24 hours. Another ultrasound of the affected leg showed that the clot was still there (and has moved from calf to thigh), so it is vital to stay on an anticoatulant but the pain interferes with a normal life. My physician has switched me to Eliquis but I am feeling some of the same pain in my lower back and bones, as well as my neck. I’ve only been on Eliquis a few days and started out at a double dose to get it working, but… I’ll give it a week or two but if I am still in this much pain, will ask her about going on Warfarin. I took that 5 years ago for 6 months and didn’t have these pains. The bloodwork is annoying but I can live with that.

  12. Sandy

    I started Eliquis mid September this year for arrhythmia and have no energy; can sleep 15-16 hours a day. I feel dull witted, short of breath and depressed. I have had 2 nose bleeds but not as severe as some mentioned in other posts. My friends and family keep asking what is wrong with me, but the only answer I can think of is side effects from Eliquis. I will be getting off this medication.

  13. Larry

    I wonder if I developed a rash in my groin only on one side. It is extremely itchy and bright red, like a diaper rash. Is this an Eliquis issue?

    • Naomi

      I’ve developed the same type of rash on my arm and leg. Only after taking Eliquis.

  14. heath

    I have been on Eliquis for a week after being on astrix aspirin for years,(which I was doing very well on,as I have Afib,diagnosed in 2006).,My cardiologist & Dr. said I must go on Eliquis. I just don’t feel well, suffering headaches & vertigo. My old Dr. said if this happens to go straight off Eliquis & back on astrix.. Your comments would be appreciated on this..

    • Brenda
      York, Pa

      I am having the headaches , bloating feeling and stomach crimps… Been on the drug since 9/18/15

  15. Eugene
    Lebanon, PA

    Do people have trouble with their leg muscles?

    • Pat

      Yes. Especially since starting elequis

  16. Pat K.

    Had first Ablation last week Cardio. wants me to start using Eliquis and Pataprazole with my existing medication which includes Nuseal Aspirin and a Statin. Diagnosed with AF would get attack normally after a night out or wedding when a lot of alcohol would be consumed.

    What I am very worried about is I am a very active individual gym, golf and walking as I am prone to put on weight and I am worried this new medication will restrict my ability to regularly exercise. Might anybody have any comments recently retired 60 yo. Also not keen on idea of taking both Nuseal Aspirin AND Eliquis. Thanks

  17. John

    Have been on Elequis now for 8 days after coming off cartia for AFib, now I am experiencing cold/flu symptoms and feel run down, Never was one for getting colds much before so I reckon its this medication.
    Don’t know wether I can stop safely now as read that it can cause stroke etc? what a predicament!
    Does anyone have any input which would be appreciated

  18. Marie

    Lord, I agree with you. The cures for a fib, all the $ made by cardio versions and ablations
    Nothing works. Now the drugs are causing dementia.

  19. Bela

    Have been on metoprolol, xarelto, eliquis, digoxin, lorazepam and occasional furosemide (Lasix) for a couple years, after a serious episode of a-fib that went into congestion heart failure. Have had a couple of those cardioversions to try to correct heart rhythm, but keep going into A-fib.

    Am presently having serious side-effects from all these drugs and just want to stop them… Have cut most meds down to 1/2 dosage (with Dr. knowledge), but have had about a week of INTENSE SEVERE LOWER ABDOMINAL PAIN (left side) and not sure what’s causing it. May have to go to E.R. for some testing because the pain is so severe and unremitting. Cannot find any comfortable position, and have to lay on back and JUST NOT MOVE to avoid the pain.

    Just did some look-ups in Physician’s Desk Reference for drugs , and they list STOMACH PAIN and LOWER ABDOMINAL PAIN in listings for Metoprolol, Eliquis, Digoxin, and Lorazepam! Also, have learned that many of these drugs can cause dehydration that can lead to kidney stones, which can also cause severe abdominal pain.

    Am starting to feel like having A-fib is better than all these problems from the so-called cures!

    • Carol

      I have just been prescribed Eliquis and am actually very scared of taking them after hearing of the awful side effects that some people have had so I don’t think I am going to take the risk but will see what alternatives there are

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