How Eliquis works | Foods to eat with Eliquis | Foods to avoid with blood thinners | Gastrointestinal side effects of Eliquis
Eliquis (apixaban) is a blood thinner medication that is used to both prevent and treat blood clots (including medical conditions like venous thromboembolism, pulmonary embolism, and deep vein thrombosis) as well as to prevent strokes and blood clots associated with atrial fibrillation (AFib).
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Many people are aware of the old faithful blood thinner warfarin (brand name Coumadin), and how certain foods need to be avoided with warfarin. What about foods with the newer anticoagulant Eliquis? Let’s take a closer look.
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How Eliquis works
Eliquis is a blood thinner/anticoagulant that works by blocking factor Xa (pronounced “ten-A”), which is a clotting factor in our blood that helps clots to form. This is sometimes referred to as a factor Xa inhibitor. There are many clotting factors in our blood, and factor Xa is one of the main ones.
Eliquis comes in a 2.5 mg and 5 mg dose and is taken twice daily.
Unlike the older blood thinner coumadin/warfarin, monitoring the PT/INR (prothrombin time/international normalized ratio) is not required while taking Eliquis.
What should you eat while taking Eliquis?
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Vitamin K-rich foods can reduce the effectiveness of warfarin, since it blocks the effects of vitamin K in the blood. However, apixaban (the active ingredient in Eliquis) does not rely on the Vitamin K-dependent clotting pathway, and instead acts on clotting factor Xa. As a result, Eliquis levels and effectiveness are not altered by vitamin K intake from foods such as spinach, broccoli, kale, brussels sprouts.
Many patients placed on Eliquis for the first time have underlying heart disease. As such, a diet rich in fruits, vegetables, and nuts is preferred over red meat, fast foods, and refined sugars. The American Heart Association has some diet recommendations online. Your healthcare provider can also refer you to a dietician if you need extra help planning a heart-healthy diet.
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2 foods to avoid with blood thinners
Fortunately, Eliquis has not been shown to have a bad interaction with any foods. The usual culprits when it comes to food-drug interactions, such as leafy green vegetables, grapefruit juice, cranberry juice, coffee, and peppermint tea, are safe to enjoy while taking Eliquis.
1. Limit caffeine
There is no direct interaction between Eliquis and caffeine. However, many patients taking Eliquis also have coronary artery disease (CAD), and often these patients have limits placed on their caffeine intake by their doctor. In addition, patients with AFib are often told to avoid caffeine altogether. Consult with your doctor if you have concerns about caffeine and Eliquis.
2. High-fat foods
A diet high in saturated fats, red meat, and fast foods tend to promote fatty plaques in your blood vessels, which can increase the risk of heart disease and stroke.
Being obese also increases your risk of blood clots and stroke. Patients who are overweight or obese, with diets high in fats are the same patients that are likely to end up on Eliquis.
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As such, switch to a heart-healthy diet, with fruits, veggies, nuts, and soluble fiber. Soluble fiber has been shown to decrease blood cholesterol levels, which can decrease the risk of atherosclerosis (fatty deposits) in the blood vessels.
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Herbs and supplements to avoid with Eliquis
Since herbals and supplements are not regulated by the FDA like other prescription medications, it can be more difficult to come by quality data on potential interactions between herbal medications and prescription meds. It’s always a good idea to seek medical advice from your healthcare provider before taking herbal or vitamin supplements. Not only can herbal medications interact with prescription meds, but they can also be dangerous if you have any liver or kidney problems.
There is some data that ginger, ginkgo biloba, turmeric, and some Chinese herbs can result in an increased risk of bleeding when combined with a blood thinning medication such as apixaban. Additionally, St. John’s wort may decrease the effectiveness of apixaban.
It is also very important to be careful taking medications like ibuprofen (Advil, Motrin), naproxen (Naprosyn), and diclofenac (Voltaren), which are collectively referred to as nonsteroidal anti-inflammatory drugs (NSAIDs), while taking Eliquis. NSAIDs and aspirin will result in a higher risk of bleeding when combined with anticoagulants such as Eliquis.
Gastrointestinal side effects of Eliquis
It’s important to watch out for signs of gastrointestinal blood loss while taking a blood thinner, which is a serious side effect of Eliquis and potentially life-threatening. The two main things to look out for in terms of this are red blood either in or on the stool, and black stool.
Red blood either mixed with stool or coming from the rectum, usually indicates something bleeding in your colon (large intestine). Black stool usually indicates something bleeding in your upper GI tract, such as your esophagus, stomach, or upper small intestine. If you notice either of these two symptoms, call your doctor right away.
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