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. Bunty
    Newcastle upon tyne

    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

      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

        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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