blood red ring

In our inbox yesterday morning was a media alert from Adverse Events, Inc., regarding the anticoagulant Eliquis (apixaban) and some new cases of colon cancer and liver injury. There is nothing in the official prescribing information regarding such possible complications.

This healthcare informatics company monitors FDA’s Adverse Event Reporting System (FAERS) looking for signals of drug problems. The researchers also obtain insider data from the FDA through the Freedom of Information Act (FOIA). This is just the latest alert regarding Eliquis, a medication prescribed to prevent blood clots in patients with an irregular heart rhythm called atrial fibrillation. The drug is also used to prevent blood clots after knee replacement surgery and to reduce the risks of blood clots in the legs or lungs from deep vein thrombosis (DVT).

Admittedly, the number of cases of colon cancer or liver damage is very small, but this will require careful follow-up to make sure there isn’t a trend developing. Adverse Events, Inc., (AdverseEvents.com) has noted other complications associated with Eliquis that have not made it into the official label. These include heart failure, kidney problems and difficulty swallowing (dysphagia).

Please keep in mind that such adverse drug reports may be coincidental and not related to Eliquis, but they deserve serious attention until we know for sure.

Established Eliquis (Apixaban) Side Effects

What we know with reasonable certainty is that this anticoagulant has some pretty serious adverse effects that are established. They include:

Hemorrhage:

  • Serious bleeding in the gastrointestinal tract
  • Serious bleeding in the brain (hemorrhagic stroke)
  • Serious bleeding within the eye

Anemia

Nausea

Blood clots if the drug is stopped suddenly. No one should EVER discontinue Eliquis suddenly without careful medical supervision. This “rebound” clotting effect could trigger life-threatening events.

Spinal procedures such as epidural anesthesia can be very dangerous for people taking Eliquis.

Serious allergic reactions (skin rash, anaphylaxis)

Other, Less Common Side Effects:

  • Low blood pressure
  • Breathing problems
  • Bruising
  • Nose bleeds and bleeding gums
  • Bleeding at the site of surgery

We don’t know about you, but whenever we see a long list of side effects our eyes glaze over. Reading real stories from visitors to this website makes such complications far more concrete. We received this message from Joe:

“Eliquis is the worst drug I’ve ever taken in my life. After only six days I developed all of the following side effects:

  1. SEVERE exhaustion. Couldn’t even walk to the mailbox.
  2. SEVERE breathlessness.
  3. Hypotension (low blood pressure)
  4. Blurred vision.
  5. SEVERE cognitive failure. Felt like my head was stuffed with cotton.
  6. Periods of rapid heart beat.
  7. Insomnia.
  8. BPH (benign prostatic hyperplasia)
  9. Ravenous appetite; absolutely craved carbs. Would have to get up in the middle of the night and eat.”

Many of Joe’s symptoms (insomnia, BPH, cognitive impairment and increased appetite) are not listed in the official prescribing information so it is hard to know if they were really brought on by Eliquis.

This story is from Margaret is far more worrisome:

I live in Queensland, Australia. My cardiologist transferred me from warfarin to Eliquis 5 mg morning and night in October 2014. I am 78 years old with heart failure plus AF [atrial fibrillation]. Yesterday afternoon I suddenly had a very major nosebleed, 6 paper towels were soaked, 3 hand towels were soaked and one bath towel was wet.

I rang one of my daughters and she rang the ambulance while she was on her way. The paramedics arrived and quickly brought the nosebleed under control. I was advised by the doctor at the 24 hour clinic to not take the Eliquis and to go see my normal doctor today. I have an appointment to see him at 2.30 pm this afternoon.

I will be telling my doctor that I want to go back on the warfarin…Yes, it necessitates regular blood tests but it is far safer than Eliquis and the other two drugs that have been developed to replace warfarin. Warfarin has an antidote, Vitamin K, whereas the others don’t…they have nothing to reverse the bleeding if it gets bad!

No way will I put myself at risk with these new anticoagulant drugs!

Margaret isn’t the only one concerned about the new generation of oral anticoagulants. The Institute for Safe Medication Practices (ISMP) issues a publication called “Quarter Watch.” It too monitors the FDA’s Adverse Event Reporting System. In the January 9, 2013 issue it noted that:

“Strong signals continued for three anticoagulant drugs, warfarin (COUMADIN) and newcomers dabigatran (PRADAXA) and rivaroxaban (XARELTO). The three drugs accounted for 1,734 reports to the FDA in 2012 Q2, including 233 patient deaths, reinforcing the conclusion that anticoagulants rank among the highest risk of all outpatient drug treatments…”

On October 17, 2013 the ISMP Quarter Watch reported that anticoagulant medications such as dabigatran (Pradaxa) and warfarin (Coumadin) contributed to the leading drug safety problems reported to the FDA in 2012. The conclusions:

“The 2012 adverse event report data show, in our judgment, that a major priority in drug safety should be to reduce the serious and fatal hemorrhages resulting from treatment with anticoagulant drugs, particularly in the older population with atrial fibrillation.”

The Bottom Line:

Anticoagulants are important drugs. They reduce the risk of blood clots that can cause strokes and other serious health problems. But these medications must be treated with kid gloves. They require careful dosing and regular monitoring. Patients must be warned about the potential for serious bleeding complications and what to do if they happen. We agree with the experts at ISMP that:

“Numerous steps can be taken to enhance the safety of anticoagulants. Unlike warfarin, neither dabigatran nor rivaroxaban have antidotes to rapidly reverse the anticoagulant effects of treatment. More and better information for clinicians is needed about how to manage hemorrhages that occur either as a side effect or as a result of accident or trauma.”

Share your own experience with the anticoagulants both positive or negative. Insert your story about Coumadin, Eliquis, Pradaxa or Xarelto in the “What Do You Think” section below.

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  1. Samantha
    Nj
    Reply

    Been on Eliquis for three months. I have noticed I have uti symptoms but no uti. I took multiple ute tests, and all negative. I don’t really have the burning when urinating but I have that constant urge to go and a little burning when just sitting. Seeing if it could be caused by Eliquis.

  2. Nancy W.
    Poplar bluff mo
    Reply

    My mother is experiencing the same side effects from eliquis. Weak, nose bleeds, sore legs, and more.

  3. Discouraged Leigh
    USA
    Reply

    I was started on Eliquis one week ago for upcoming cardiac ablation . I am a runner and a very active . I only weigh 124 pounds literature says anyone under 60 kg (think I’m 54 kg) should only take 2.5 mg twice a day . My electrophysiologist has put me on 5 mg twice a day . The same amount my 240 pound brother-in-law takes . Needless to say I feel horrible. Weak feel like I can’t stand on my legs at times hard to get through the day. I tried to talk my cardiologist into cutting my dose back to 2.5 twice a day but he won’t. Any thoughts . Very discouraged as I am type A and right now my life is sedentary except that I do make myself go out and do a run every day just not as far . Thank you for your input

  4. Guy
    Illinois
    Reply

    Started Apixiban (eliquis) one month ago after diagnosed with DVT. I no longer sleep through the night. Takes an hour or more to fall asleep and then I only sleep about a half hour before waking and then taking another hour or two to fall asleep again. Since I started on this drug I feel drained and exhausted all the time. I can’t stand on my feet for more than about 40 minutes or walk more than a hundred feet or so without being totally winded. I have a cough all day long and a hoarse throat and sometimes trouble catching my breath. A trip up or down even just a few stairs wipes me out.

  5. Sallie
    Leicestershire UK
    Reply

    My blood pressure has dropped slowly from 140/95 prior to Apixaban to 107/77 today. I have been experiencing unsteadiness with intermittent breathlessness and have periods when I feel thickheaded. 61 years old and have been on Apixaban 4 weeks due to PEs after surgery. My heart rate has also dropped but this may be because of PE resolution. While taking double dose at beginning the symptoms were worse. However, they are there everyday and if due to side effects they are severely hampering my recovery.

  6. Colleen
    Gloucestershire
    Reply

    I have just been reading the comments from people using the drug apixaban. I am somebody who has to be regulalary transfused due to a rare blood disorder. Feb 2018 i was diagnosed with AF and was put on to apixaban. My transfusions at the time were every eight weeks, I started the drug and suddenly my transfusions started to become more regular 6 weeks then 5 and this time 4, I feel very unwell headaches tummy pain ( something i have never suffered before). I am very depressed and i am struggling to keep going my limbs hurt i am breathless i can’t sleep and just feel generally unwell even sometimes feeling like i don’t want be here, although not a suicidle type of person, just very fed up and unhappy. If anybody knows of an alternative drug that will not compromise my red blood cells, i would be glad to hear from you..

  7. Joanne Stevenson
    Ft. Collins, Co.
    Reply

    I have been on Eliquis for over 3months after being on Warfarin for 12 years. My first side effect was rash on arms & legs…then scalp dryness & scaling.
    In the past two weeks my vision started to deteriorate a great deal. Today in a restaurant I could not read the menu. I now realize I must take a magnifying glass.. although I have not had great vision for the past yearIt has greatly deteriorated very recently. I asked my primary care Dr. about it & she ordered blood tests which I took today. I asked technician what tests were ordered & she stated CBC & thyroid….since my daughter is her patient & has thyroid.
    Also my hearing is getting much worse. True I M 85 years old & find it strange to get so many things wrong so recently. I feel ThevEliquis is somehow responsible. Next step. Report to FDA ?

  8. Sophia
    UK
    Reply

    I have been asked to take Apixaban temporarily pre and post my cardiac ablation surgery. I have been taking it now for five weeks. I felt VERY ill at first, and caught a cough which devleoped into the worst chest infection I have ever had in my fifty two year long life. I could not shake it but actually got worse and worse, until I thankfully remembered Black Seed Oil which cured it quickly. I thought it was senseless to take antibiotics just in order to stay on the drug that was making me ill, and was intending to stop taking the drug as my surgery would have to be delayed anyway. Luckily I got better in time.
    Here are the symptoms I felt: groggy, exhausted and unable to do things except the required minimum, depressed, and a lot of mental fogginess which is totally unlike me. Now, these feelings are decreasing as my body presumably adapts. I was not warned about stopping suddenly. I have to wait until four months post op for an appointment with the cardiologist. I want to stop taking this drug before then but had better find out how to do so safely, and how long to stay on it post surgery.

  9. Angela S
    Southfield
    Reply

    A couple of days after starting eliquis I began having vivid dreams & sleep disturbances. They are the type of dreams that when you wake up you’re not sure if it was a dream or a memory of something that really happened, and you don’t feel like you slept. I wake up after about 3-4 hours and am awake 1-2 hours before I can get back to sleep. Now after being on Eliquis for 1 month, I am hungry all the time. None of these are known side effects of eliquis. I’ve spoken to my pharmacist, my perscribing doctor & the manufacturer.

  10. K.h.
    Enumclaw
    Reply

    I have been on Elouise for a couple years, never bruised. 5 months ago I quit drinking and now I’m bruised everywhere, mostly fingernail size red purple ones on my arms, some on legs but for no reason. They just pop up. I look diseased. Is this normal?

  11. Kevin story
    Salem va
    Reply

    I think Eliquis causes throat spasms tightness in the throat

  12. Michael
    Leicestershire
    Reply

    I have a undiagnosed blood clotting disorder. When I was 27 I had a D.V.T. That went from my Knee to the base of my aorta. I was bedridden for 2 month. Warfarin (Coumadin) saved my life. I took it the first time for 6 months and then I was done with it. About 6 months after I came off it I had (and still have) chronic edema in my leg and I developed Cellulitis after being laid up in bed with that for a couple of days I developed a second clot. The doctors concluded that I was prone to spontaneous blood clotting and put me on Warfarin for life. They are now 9 years later trying to change me to apixaban. I worry because I am a lot younger than the average person who would take this drug for the rest of their life and if I live an average life I’ll be on it for 40-50 years. I wonder If you have any information from long term users with information that can help me to decide whether or not to move to apixaban. Any help, advice or information would be very welcome. Thanks.

  13. Bunty
    Newcastle uk
    Reply

    6th post on this great site,we are all suffering our awful side effects,I have been on apixiban 5mg bd got 3 years following small partial lobe strokes.i Know can’t walk far my knees are huge due to arthritis but this condition has exculated due to drug ,I’m very short of breath and unable to walk far or climb Stairs,I m a nurse still working part time I’m 55 but feel 85 wish I had the courage to stop ✋ taking it ,all my gp and medical colleagues tell me it’s the best drug but I feel it is taking my quality away unable to do much can’t walk my dog or go shopping or meet friends if it involves walking,so low and a depressed,Keep strong all of you and let’s pray for a miracle 🙏

  14. Larynn
    Waukesha WI
    Reply

    I went in for a CT scan of my chest and they saw two blood clots in my left lung. Everything else looked good. Which they said it’s from the birth control pill I was taking. So then I was prescribed Eliquis for three months, ( my three months are done). I have just taken another CT scan and now I have cancer in my chest they think it might be lymphoma. It just seems like a weird coincidence!

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