Eliquis and alcohol: can they be used together?

Have you just picked up your Eliquis medication from the drug store? You may have noticed the alcohol warning labels. Alcohol and medicines don’t generally go together. Ideally, they should be like two sides of a coin never interacting! Here’s why taking Eliquis with alcohol isn’t a good idea. But let’s first start off by understanding what Eliquis is.

What is Eliquis?

Eliquis is a fairly new anticoagulant medication that was approved for use in 2012. In comparison warfarin (Coumadin) is the most widely used blood thinner that has been around since 1954. Eliquis works by blocking an important process in the body called blood clotting. It involves many complex steps that lead to coagulation (the process of blood thickening). The role of Eliquis is to eliminate blood clots and interfere in the blood clotting process in certain types of patients.

What is blood clotting?

When you get hurt, blood cells called platelets gather at the injury site and form a blood clot. These cells are sticky, and they form clumps creating a plug. Clotting factors are also released from platelets that help form a mesh to form the plug to close the wound.

The clotting process is essential when you’re injured. Sometimes, however, a blood clot can appear in blood vessels such as the aorta artery that supplies your heart or brain with oxygen-rich blood. When a clot blocks blood flow to your heart, it can cause a heart attack. If it blocks the blood flow to your brain, it can cause a stroke. Blood thinners like Eliquis are used to prevent strokes and potentially fatal blood clots.

The use of blood thinners such as Eliquis in groups of patients who have a higher risk of bleeding due to heart disease or heart conditions, risk of stroke, and high blood pressure is common.

How does Eliquis work?

Eliquis contains the active ingredient apixaban, an anticoagulant medicine that prevents blood clots from forming. Eliquis is classed as a Factor Xa inhibitor. It blocks the clotting factor called factor Xa which prevents clots from forming i.e. decreases blood clot production. Clots can be stopped from forming and getting larger, however, apixaban can not break up clots that are already there.

Other medications in this category include Xarelto (rivaroxaban), Savaysa (edoxaban), and Arixtra (fondaparinux).

Eliquis has several indications. Eliquis can be used to:

• Reduce the risk of stroke and embolism in patients with atrial fibrillation
• Prevent deep vein thrombosis (DVT)
• Treat DVT
• Treat pulmonary embolism
• Reduce the risk of a recurrence of deep vein thrombosis and pulmonary embolism

Occasionally your healthcare provider will want to check the health of your kidneys when taking Eliquis, with a blood test. You do not need to have routine blood testing to check the amount of apixaban in your body.

Side effects with Eliquis

Bleeding is the most common and serious side effect of Eliquis. If you take Eliquis you have an increased risk of:

• Bleeding gums when you brush your teeth
• Nosebleeds
• Bruising easily
• Small cuts bleeding more than usual
• Longer or heavier menstrual bleeding (women)

Is it safe to drink alcohol while taking Eliquis?

It is best to avoid alcohol while taking Eliquis. This is because it can increase the risk of bleeding in your stomach and intestines. If you do drink alcohol, the recommended alcohol consumption is no more than 1 drink a day for a woman, and no more than 2 drinks at a time for a man.

The risks of combining alcohol and blood thinners are even more dangerous if you also take another medication that also interacts with blood thinners. Drug interactions with the following medications are possible:

• Antibiotics e.g. Biaxin
• Antifungals e.g. Nizoral
• Antidepressants e.g. Prozac
• Anticonvulsants e.g. Equetro
• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• Foods rich in vitamin K e.g. dark, leafy green vegetables
• Cranberry juice

Does Eliquis affect how other medicines work?

You may have a higher risk of bleeding if you take Eliquis while you are taking other medicines that also lower your body’s ability to form clots. These include:

• Aspirin or products that contain aspirin

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, and others), celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), indomethacin (Indocin), ketoprofen (Actron, Orudis), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene)
• Warfarin (Coumadin)
• Any medicine that contains heparin
• Clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta)
• Dabigatran (Pradaxa), rivaroxaban (Xarelto)

Other drugs may also affect how apixaban works in your body. It is very important to tell your doctor or anticoagulation clinic whenever you start or stop any medicine. This includes medicines you can buy without a prescription, herbal products, and vitamins.

Are there resources available to help me reduce my alcohol intake?

If you think excessive drinking such as binge drinking and heavy drinking is something you need help with The Substance Abuse and Mental Health Services Administration (SAMHSA) can be contacted.

Binge drinking is described as consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours and is the most common form of excessive drinking. Heavy drinking is defined as consuming more than 4 drinks on any day (male) or more than 3 drinks on any day (female)

If your alcohol intake looks excessive, seeking medical advice from a healthcare professional is recommended. They can help you access the correct medical attention for your alcohol use.