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.

ELIQUIS (APIXABAN) SIDE EFFECTS & INTERACTIONS: 

  • 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.

INTERACTIONS WITH OTHER DRUGS:

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. Dave
    Arizona
    Reply

    Great site with some affirmation from others to problems I started having after Pradaxa (2 month) with very had to swallow problems & now (Eliquis) for 3 months, with increased bowel probs and some weight loss , much increased ear ringing, sudden short term memory loss and very sore muscles even though I have exercised 3 times a week with some weights, rowing machine and Nustep for years and in good shape. I take 5mg 2 times a day for afib and am going to consult with all my doctors, from primary to internal to heart doctor for other info on my increased probs.
    I will have my primary ck blood and stool tests to rule out those before cking on internals and back to heart doctor to cover all bases though and then back to heart Dr.
    Good luck to all with serious concern, Dave.

  2. Bunty
    Newcastle uk
    Reply

    I have posted many times on this site requarding my apixiban hell 17 months on it, and I’ve aged 20 years. Am unable to walk far, am fatigued, depressed, weight has increased, headache, ringing in my ears, just feel ill all of the time. My HGB has now dropped from 14.5 to 11.3 and am bleeding where from???? Nobody interested, even contacted the company. No help or advice.

  3. Jen
    Newcastle
    Reply

    I’ve been taking eliquis 5 mg for a couple of weeks awaiting my heart op and I’m feeling so tired I usually sleep about 7 hours at night I’m now absolutly shattered all I do all day is yawn and I cannot wait for bed. I’m now sleeping 12 hours and my quality of life is down the pan. I’m so lethargic it’s unbeliveable can I change to a different drug ?

  4. Elizabeth
    Waxhaw, NC
    Reply

    I, too, have had a number of worrisome and troublesome side effects from taking Eliquis, and
    I have only been taking the drug for about a week and a half. I am glad I came upon this website because I have been stressing over a constant state of complete exhaustion and shortness of breath ever since starting the drug.

    I have a lot of joint pain, dizziness, nausea, and general feeling of malaise that never seems to end. I am really worried about continuing OR stopping Eliquis after reading all the accounts listed on this webite. Either way, it’s a crapshoot as to whether can avoid another stroke (had one in June 2017) on or off this medicine and whether there is actually an alternative for me.

  5. Lisa R
    Texas
    Reply

    WoW! Had a cerebellum stroke May 17th/2017. I had hit the top of my head 5 hours earlier on metal in the car. Doctors do not believe my stroke was caused by the head hit. I believe differently. But, I do not have M.D. after my name…only C.S. CS stands for “common sense”. I was life lighted to a hospital and was put on Warafin. I stayed there 5 days and do not remember much except falling and hitting my head on a bathroom fall. No tests after that fall.

    Discharged to a rehab place. I could not stand without a wheelchair/walker. Rehab for a month. PT was just so so. Released to 6 weeks of home PT..ladies were 50% better. I thank God for my walker as I cannot function without it. My head is killing me all the time. One doctor wanted me off Warafin. Finally placed on Eliquis…5mg x 2 a day. I was told they saw a blood clot in an artery in the cerebellum and I will never have a stroke again. I doubt that.

    My common sense steps in and I know better. I do not want another stroke. They said it had to be A-FIB from the heart that caused the stroke. I say it was me hitting my head in the car that caused the stroke. My only symptoms was my eyes. I could only see the ceiling and the floor and did not know where I was standing. This was with me looking at the wall. I was very scared. Just finished one month of Eliquis. The cost will put me in the donut hole as I am on Medicare. Very expensive. I will see one of the doctors in 2 weeks. I am wondering if strong aspirin instead of Eliquis would help me and with Plavix. I am doing research and need sound answers. I feel dizzy and light headed and act like I am in a stupor.

    I walk ziz zaged. This is NOT normal. I am 75 years young and was very active. I am wondering if younger people on private insurance receive more attention than those on Medicare. These are just my thoughts. I feel Stroke victims need continuous care to achieve stability under a Neuro’s care. My BIL is taking XARelto for his A-Fib. He never had a stroke. Same doctor RX’d me Eliquis. BIL has no side effects. Love to read patient’s views.

    • Mike
      California
      Reply

      I am a 70 year old male and I have been taking Eliquis for about three years now, ever since I had an episode with AFIB that landed me in the hospital. It took three days for my pulse to finally return to a normal level.

      During this hospital visit, it was discovered that I have slight leakage from the aortic valve and my cardiologist decided to put me on Eliquis. I have had no side effects from it at all and I’m happy that it doesn’t require office visits to monitor its effects,

  6. Rita
    ohio
    Reply

    I took one pill last night, 2.5 ml. I had trouble walking, feeling like I might fall over, and was dizzy. This morning my lip is swollen, my pacemaker incision feels tight and hurts, and my eyes are blood shot. I have macular degeneration. I was allergic to Cardizen and Lopressor.

    Not sure what I should do next?

  7. Gale
    TX
    Reply

    I am 73 yr old female, heart disease & 3 stents since 2009 & have have had AFib for over 2 years & now it has gotten to be nearly a daily occurrence. I tried Warfarin in January when I was having AFib about twice a month & could not tolerate it, so chose to not take anything.

    I’ve been taking a lot of herbal supplements that thin the blood. After spending Tuesday in the ER & IV Cardizem did not convert me, I was admitted to CCU for monitoring & for a Heparin Drip. I finally went back to NSR about 11pm Tuesday night in the hospital. I was released at 9pm Thursday night.

    My cardio now has insisted I go on Eliquis. I’m really concerned about it & very hesitant, but they gave me the first dose in the hospital last night & I have taken one today. Now I’m wondering about all the herbal supplements that I take & which ones I need to stop. Hoping someone has similar circumstances that can tell me their experience

  8. Judy
    Arizona
    Reply

    My mom is taking Eliquis for A-Fib. She is also on Cartia/Metroplol. I read all three drugs create memory loss. I am trying to figure out which drug is starting memory loss for her, as she is frightened by this new side effect. Some dugs can be worse than the illness. I am determined to find which is worse and get her off of it. Not worth it.

  9. Jennifer
    England uk
    Reply

    Hi, I have been on Apixaban since last November after being diagnosed with afib. and am experiencing head aches in the night and ear ringing. I also have anxiety at night. Does anyone else have this, please?

  10. Noah
    Chapel Hill, NC
    Reply

    Eliquis is a lot easier than coumadin/warfarin… when it works. No monitoring, no visits every month. No worrying how that salad will effect my blood levels.

    Plus the added “benefit” of no way of actually measuring how well it is working in any particular individual or even exactly what it is effecting to achieve the unmeasurable/unevaluatable results it achieves. And there is no protocol for reversing the effects should bleeding become too severe.

    I am on it, now, for 20 months and have had a bit more bleeding from wounds than in the past but nothing too severe. I am not plagued by fatigue or foggy thinking.

    But I am beginning to wonder exactly what this drug is doing since there are no tests for its efficacy.
    I wonder how it even got approved in the first place. There is no test to measure whether it is working or not. That disturbs me the most.

    • Matt
      IL
      Reply

      Yes, it is very tempting to take Eliquis because you do not need to get frequent INR tests done. BUT ELIQUIS IS NOT A WONDER DRUG. I tried it for a few months, and it almost ruined my life. Lots of neck and shoulder pain, weak muscles in my legs, poor sense of balance, and I felt like I aged 20 years. I am a pharmacist, age 76, and very active. Like brisk walking at 4+ MPH for one hour. This was my normal routine for 35 years.

      A few month on Eliquis, and I could barely get on the treadmill. So I switched to Coumadin, 5 mg., and after about one month my life is fully restored. All these problems stopped, but it took awhile to reverse. I will NEVER EVER take either Eliquis or Xerelto again. It is fairly new, and the doctors simply do not know how bad these two drugs can be for an ACTIVE PERSON. For debilitated and inactive folks, these two may work fine. It takes at least seven years to really see the bad side effects of drugs, and these two have only been around for about five. So beware here. THIS IS NOT “IN YOUR HEAD”!!

    • Bunty
      Reply

      Hi, Jen,
      I have lots of side effects so I can sympathise with you. I want off this drug. Regards, Bev

  11. Dan
    Southern California
    Reply

    I had an cryoablation procedure three months ago. I started taking Eloquis two weeks before the procedure. Imedimately I noticed a lack of energy, diziness and some upset stomach. One month after starting the Eloquis and two weeks after my procedure I had a two and a half week bought of sever stomach problems.

    I could not eat much and lost ten pounds. After that went away I continue to have stomach pain daily and episodes of burping. The stomach pain is most sever first thing in the morning and then again late in the day.

    It is aweful. My Cardiologist told me that at about six months I can get off of the Eloquis and I am very anxious for that step in the process.

    • Quantumnerd
      Arizona
      Reply

      I just looked up symptoms on google and was directed to the site. I am on Eliquis now for a month or so now, and I was sleeping and could feel burning pains in my stomach when I woke up I ate some cereal and immediately felt nauseous and bad stomach pains, I was really dizzy too. I had been taking two pills a day, but they told me to go down to one, so yesterday was the first day I went down to one, now I’m afraid due to I don’t know why I had sudden stomach pain, dizziness, strange feeling in my head. :/ This stomach is really bad though. Hope your feeling better. Did you find out why you had the stomach aches? Is it the Eliquis side effects? Thanks.

      • Josephine
        Tennessee
        Reply

        I also take Eliquis for deep vein thrombosis and pulmonary embolism. It bothers my stomach as well. I have had dizziness (room spinning) but didn’t associate that with Eliquis at the time. I came close to death when the clots occurred, and the doctors say Eliquis is the best treatment for DVT and PE. I feel I have no other choice but to take this medication because of my serious condition. It is extremely expensive.

  12. Brian
    rm14 1qe
    Reply

    I am relieved to know that I am not alone in suffering from most of the side affects mentioned by others. I was put on to this medication without any consultation following a short hospital stay in Dec 16, having used warfarin successfully for over 10 years (if it works don’t fix it) What is of serious concern to me is how to safely stop using this flawed medication
    , I guess it is up to the Cardiac consultant to advise.

  13. Ed
    Schenectady ,N.Y.
    Reply

    i just started taking this drug about 3 weeks ago after being changed from warfarin,It makes me feel terrible.I’m extremely tired all the time, feeling lightheaded,nauseus and stomach cramps and stomach bloat.Never had bad side affects with any other med like im having with this

  14. Julie
    Australia
    Reply

    I started taking 5mg twice daily of Apixaban in May 2016 after suffering a stroke which was said to have been caused by Atrial Fibrillation and I take 75mg twice daily of Metoprolol for this condition. I had one cardioversion but it only worked for 24hrs. An Ablation was not suitable for me and I now have a PaceMaker which I had blamed for my depression, lack of enthusiasm, continual tiredness, aching limbs, shortness of breath and now excessive body heat -almost like hot flushes. My GP put me on an Antidepressant which has certainly helped and I don’t have untold sadness and continual crying times anymore but the other symptoms are still there! After reading other comments I realise it is not the PaceMaker but the Apixaban reeking havoc with my equilibrium but what can I do. My Eurologist and Cardiologist say Apixaban and Metoprolol are the best drugs on the market for my condition.
    I am continually aware I may have another stroke and may not be as lucky next time with my recovery so I will continue to take the Apixaban, like it or not but at least I now know what is causing my other symptoms.
    Julie

  15. Dwina
    Sunderland UK
    Reply

    I’ve been on apixaban since early December, since finally diagnosed with atrial fibrillation.
    I’m also classed as at a high stroke risk becausecof high cholesterol and years of uncontrolled hypertension, and family history.
    I’m constantly exhausted, have severe headaches and tinnitus, very constipated, bad joint and muscle pain, and feel very depressed.
    I too was in the caring profession, for over 40 years.
    I now feel very anxious, particularly as there is no antidote to this drug.
    Its good to read other’s experiences, as I sometimes think my GP thinks its all in my mind!

  16. Don
    FL
    Reply

    So many of the negative side effects of Eliquis are coming out after the short years it has been in use. Coming off Eliquis may cause a stroke, so be very careful to evaluate the pros and cons of going onto this drug at all. If it is just to lower the chance of a clotting event, and is not absolutely needed, then consider sticking with natural blood thinners…. Your quality of life is also worth something.

  17. lee
    indiana
    Reply

    I have been on Eloquis since October. I have to take a nap in the afternoon and usually wake up with a headache and ringing in my ears. I take 5 mg. twice a day.

  18. Bunty
    Newcastle upon tyne
    Reply

    Hi, this is my third post on this fantastic site, knowing there are people like me who are struggling with this medication. I had 2 partial lobe strokes in May 2016. I’m 52 years old and a staff nurse had a very full life and a job I adored.

    Since Apixiban came into my life, I’ve gradually declined into a very anxious tired person severe joint pain, hair loss and terrible mood chronic fatigue, had to leave my job and get new nursing position. I have given my life to nursing and caring but know can’t get myself sorted wish I could get in touch with the lady who posted a comment from Scotland.

    I know how you feel!!! Asked if I can go on Warfarin, told no as it is a drug of the past. What does the future hold as all these side effects we have are not listed on leaflet inside medication box. Good luck to you all x

    • kelly
      newcastle
      Reply

      Hi
      I have been on Apixaban for 10 weeks now while I have an Ablation,hope to come off it in the next 6 weeks after my 12 week post procedure check.
      I to have no energy,dizziness,tiredness and headache. I cannot wait to get off this drug as I am sure it is this that is causing these symptoms. I did not have a stroke risk so hopefully just need to take for a few more weeks. I am 5 weeks post Ablation thought it was the procedure giving me these symptoms but reading various forums I am convinced it is the Apixaban.

      • polly
        Durham
        Reply

        Hi Kelly
        I too have had an Ablation and having exactly the same symptoms. Convinced it is the Apixaban but Drs seem to dismiss this -just send you for bloods etc.Never felt like this before taking Apixaban.

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