What are the common side effects of ELIQUIS?

The most common side effect of Eliquis (apixaban) is bleeding, which happens because the medication is an anticoagulant (blood thinner).

Common Mild Side Effects

• Minor bleeding: This includes bruising more easily, nosebleeds, bleeding gums when brushing teeth, small cuts taking longer to stop bleeding, or heavier menstrual periods.
• Nausea: Mild stomach upset or feeling sick.
• Headache: A dull or throbbing ache that often improves as your body adjusts.
• Anemia: Low red blood cell levels that can cause mild fatigue or paleness.

Serious Side Effects to Watch For

• Severe or uncontrollable bleeding: Bleeding that will not stop, pink/red/brown urine, or bright red and black/tarry stools.
• Spinal or epidural blood clots: A rare risk during spinal procedures or anesthesia that can cause back pain, tingling, or paralysis.
• Increased blood clot risk: Stopping Eliquis suddenly without talking to your doctor greatly raises your risk of a stroke or dangerous clots.
• Severe allergic reactions: Swelling of the face or throat, rash, or trouble breathing.

Tiredness and weakness are not official or common side effects in clinical trials for Eliquis, but many people still report feeling exhausted while taking it.

Why You Might Feel Tired or Weak

• Anemia: Eliquis is a blood thinner. It can cause hidden or minor bleeding. This blood loss can lead to anemia (a low red blood cell count), which makes you feel weak, tired, and dizzy.
• Healing from a Condition: Many people take Eliquis after surviving a dangerous blood clot, deep vein thrombosis (a blood clot in a deep vein, usually in the leg), or a pulmonary embolism (a blood clot in the lungs). Your body uses a lot of energy to recover from these serious medical events.
• Mixed User Experiences: On platforms like Mayo Clinic Connect, opinions are mixed. Some users report strong fatigue and low energy, while others feel fine or believe the tiredness comes from other health issues.

When to Call a Doctor

Sudden or severe weakness can be a warning sign of a dangerous medical problem, such as internal bleeding or a stroke.

Seek medical help right away if your tiredness or weakness comes with:

• Dizziness or confusion
• Pink, red, dark, or tarry stools
• Pink or brown urine
• Sudden severe headaches or numbness

Most people tolerate Eliquis well, with non-major bleeding side effects occurring in roughly 2% to 4% of patients, and major bleeding affecting 3% or less.

Common and Serious Side Effects

• Minor bleeding: Affects 2% to 4% of users, including nosebleeds, bleeding gums, or heavier periods.
• Major bleeding: Occurs in 3% or less of patients, involving serious or unstoppable bleeding.
• Liver-related effects: Impact about 1% to 2% of users, causing elevated liver enzymes.
• Other mild effects: Nausea, anemia, and easy bruising happen in a small percentage of clinical trial participants.

While taking Eliquis (apixaban), you should avoid certain medications, foods, and supplements that can increase your risk of dangerous bleeding or make the drug less effective.

Unlike older blood thinners like warfarin, Eliquis does not require you to avoid vitamin K-rich leafy green vegetables. Instead, focus on avoiding the following:

Medications to Avoid

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Avoid pain relievers like ibuprofen (Advil, Motrin) and naproxen (Aleve). They irritate the stomach lining and impair clotting, significantly raising the risk of gastrointestinal bleeding.
• Aspirin: Do not take daily or occasional aspirin unless your cardiologist or doctor explicitly prescribes it. Check cold and flu multi-symptom over-the-counter packages, as many contain hidden aspirin.
• Certain Anticonvulsants and Antibiotics: Drugs like rifampin, carbamazepine, and phenytoin can lower Eliquis levels in your body, raising your risk of blood clots.

Foods and Drinks to Avoid

• Grapefruit and Grapefruit Juice: Grapefruit blocks the liver enzymes needed to break down Eliquis. This causes the medication to build up to unsafe levels in your blood, increasing bleeding risk. Also limit related citrus fruits like limes, pomelos, and Seville orange marmalades.
• Excessive Alcohol: Heavy or binge drinking impairs liver function, irritates the stomach, and increases the danger of internal bleeding or accidental falls. Moderate or occasional light drinking is generally considered low-risk by many providers, but it is best to confirm personal limits with your doctor.

Supplements and Herbs to Avoid

• St. John’s Wort: This herbal supplement speeds up the breakdown of Eliquis, making the medication far less effective at preventing clots.
• Bleeding-Enhancing Supplements: Avoid or use extreme caution with high-dose vitamin E, fish oil, ginkgo biloba, turmeric, garlic supplements, and ginger extracts, which can amplify blood-thinning effects.

Eliquis (apixaban) can affect your legs in specific ways, primarily by treating or causing certain symptoms related to blood flow and rare side effects.

Treating Leg Clots (Deep Vein Thrombosis)

• Doctors prescribe Eliquis to treat Deep Vein Thrombosis (DVT), which is a blood clot that forms in a deep vein, usually in the leg.
• It helps reduce pain and swelling caused by these clots.

Potential Leg Side Effects

• Muscle and Joint Pain: Some patients report experiencing pain in the leg muscles, joints, or knees while taking Eliquis.
• Weakness and Spasms: Muscle weakness or leg spasms can occur in a small percentage of users. On the Mayo Clinic Connect forum, users share mixed opinions, with some reporting leg weakness and fatigue that improved after stopping the medication.
• Anemia-Related Cramps: Eliquis can increase bleeding risks, leading to anemia. Low red blood cell counts can sometimes cause leg cramps and fatigue.
• Spinal Procedure Risks: If you have a spinal procedure or epidural while on Eliquis, a blood clot can form around the spine and cause leg numbness, tingling, or severe weakness.