Your blood’s ability to clot is essential to protect you from bleeding out whenever you get a small cut.
However, if your blood clots too much, it can block the blood flow in your artery or vein and lead to serious, sometimes fatal, issues.
It’s estimated that as many as 900,000 people in the United States will get a blood clot each year.
Once you get a blood clot, you’re at a higher risk of developing another one in the future.
That’s where anticoagulant drugs come into play, helping to reduce your risk of developing a blood clot.
Eliquis is one type of anticoagulant that is popular for its safety and not requiring routine lab monitoring.
We’ll discuss Eliquis and explore some of its alternatives in this article.
What is Eliquis?
Eliquis is the brand name for a medication called apixaban, a prescription anticoagulant (blood thinners).
Anticoagulants help reduce your risk of blood clots by inhibiting the formation of blood clots – they don’t actually make your blood thinner.
Blood clots can cause serious health problems such as pulmonary embolism (blood clot in your lungs), heart attack, stroke, transient ischemic attack (TIA), or a blood clot traveling to other parts of your body, such as your leg (deep vein thrombosis).
Eliquis works by blocking a specific clotting factor called factor Xa. Your blood can still clot while taking Eliquis, but it will happen more slowly, which means you may be at a greater risk of excessive bleeding (and bruising) if you have an injury.
The Food and Drug Administration (FDA) first approved Eliquis in 2012 to help reduce the risk of stroke and blood clots in patients with non-valvular atrial fibrillation (an abnormal heart rhythm not caused by an abnormal heart valve) and again in 2014 to help reduce blood clots following hip and knee replacement surgeries.
Finally, the FDA approved Eliquis again in 2014 to help treat deep vein thrombosis (DVT) and pulmonary embolism (PE), which occur from blood clots.
Eliquis is manufactured by Bristol-Myers Squibb Company and comes in 2.5-milligram- and 5-milligram tablets.
Eliquis can be taken with or without food and is taken twice daily. The maximum daily dosage of Eliquis is typically 10 milligrams twice daily.
What are the side effects of Eliquis?
Anticoagulant medications come with serious potential risks and side effects. Some of the potential risks and side effects include:
- Bleeding from cuts that take longer to stop
- Bleeding from your nose or gums
- Dizziness
- Bruising easily
- Excessively heavy menstrual bleeding
- Minor bleeding
- Nausea
Your risk of bleeding can increase if you take other anticoagulant drugs and certain over-the-counter medicines like naproxen (Aleve) and ibuprofen (Advil), so it’s important to discuss which medications you can take while you’re on Eliquis.
Pharmaceutical alternatives to Eliquis
Below, we discuss 5 prescription alternatives to Eliquis.
Pradaxa
Pradaxa (dabigatran) works to thin your blood by attaching to thrombin, your body’s main clotting agent, to prevent it from forming a clot.
Some of the most common side effects of Pradaxa are upset stomach and bleeding.
According to a study on patients with non-valvular atrial fibrillation, Eliquis and Pradaxa were superior to Xarelto in terms of reducing bleeding risk.
Xarelto
Xarelto (rivaroxaban) works similarly to Eliquis by blocking the clotting factor called enzyme Xa.
According to a 2021 study that directly compared Xarelto vs Eliquis, Eliquis was superior for stroke prevention in patients with atrial fibrillation and in reducing severe bleeding.
Like Eliquis, there aren’t any generic options for Xarelto, which means it can be quite expensive, especially without prescription or health insurance coverage.
Savaysa
Edoxaban (Savaysa) is in the same drug class as Eliquis and Xarelto and works to block the Xa clotting factor. Savaysa has a once-daily dosing compared to Eliquis’ twice-daily dosing.
Coumadin
Warfarin (coumadin) is an anticoagulant, but it doesn’t work the same way Eliquis does. Coumadin works to thin your blood by blocking the production of clotting factors that are dependent on vitamin K.
Because vitamin K is found in many foods (especially green vegetables), there are special considerations for your diet while taking warfarin, which is one drawback.
In addition, taking Coumadin requires regular INR testing to measure the thickness of your blood.
Your healthcare provider might change your dosage of Coumadin based on your INR to ensure you’re at a therapeutic dose.
To learn more about coumadin vs eliquis, we have a dedicated article for that.
Heparin
Heparin is only available for intravenous use and is primarily used in hospital settings, such as open-heart surgery, kidney dialysis, and blood transfusions, among others.
Part of the way heparin works is by neutralizing certain coagulation factors, such as antithrombin III.
Is there a generic for Eliquis?
Choosing the generic version over the brand name is generally much less expensive, though not all drugs have a generic version.
The FDA approved a generic version of Eliquis called apixaban, which is the active ingredient of Eliquis.
However, the generic version is not yet available since Eliquis’ manufacturer extended their patent to at least 2026, which means a generic medication won’t be available until that time, at the earliest.
Natural blood thinners
Some foods and drinks have natural blood-thinning properties. You shouldn’t stop taking any prescription anticoagulants in favor of natural blood thinners because they won’t be as effective, which could cause a dangerous blood clot.
Vitamin D
Vitamin D has a natural anticoagulant effect. In fact, low levels of vitamin D are associated with an increased prevalence of deep vein thrombosis (DVT), suggesting that adequate vitamin D intake may help prevent blood clots to some extent.
There aren’t many foods that are naturally rich in vitamin D (many people choose to take a vitamin D supplement), but some foods that contain vitamin D include:
- Cod liver oil
- Salmon
- Swordfish
- Tuna fish
- Orange juice fortified with vitamin D
- Dairy and plant milk fortified with vitamin D
- Sardines
- Beef liver
- Egg yolk
- Fortified cereals
High-salicylate foods
Salicylates are compounds found in some plant foods. Salicylates can block the action of vitamin K, which can promote blood clotting (remember that Coumadin works by blocking vitamin K’s clotting action).
Derivatives of salicylates such as salicylic acid are used to make aspirin, a medication that can be used as a more mild blood thinner if you don’t have a high risk of blood clots.
Some foods and drinks that are high in salicylates include:
- Vegetables like broccoli, cauliflower, cucumber, mushrooms, radishes, spinach, and zucchini
- Tomatoes
- Fruit juice (apple, grape, orange, and grapefruit juices)
- Fruits like apples, avocados, berries, cherries, grapes, peaches, and plums
- Spices like thyme, rosemary, curry powder, paprika, and garam masala
- Black, green, and herbal teas
Vitamin E
According to data collected in a study, vitamin E supplementation might help reduce the risk of blood clots, especially if you’re genetically at risk of developing clots or have a history of forming blood clots.
Taking too much vitamin E can cause excessive bleeding, so you shouldn’t take vitamin E supplements while on Eliquis unless you speak with your healthcare provider.
The risk of bleeding from vitamin E toxicity is more prevalent with doses above 1,000 milligrams per day.
The amount of vitamin E in the study mentioned was 600 IU/day. However, you can find vitamin E naturally (in lower concentrations) in foods like:
- Wheat germ oil
- Sunflower, safflower, and soybean oil
- Sunflower seeds
- Almonds
- Peanuts, peanut butter
- Beet greens, collard greens, spinach
- Pumpkin
- Red bell pepper
- Asparagus
- Mango
- Avocado
Reasons people might stop taking Eliquis
If you have atrial fibrillation or another health condition that increases your risk of developing a blood clot, it’s likely that you may need to take blood thinners long-term.
If you need blood-thinning medications, you might stop taking Eliquis due to an allergy, intolerance, or to switch to another type of anticoagulant.
Another reason you might stop taking Eliquis is if you only needed anticoagulant therapy short-term.
Some patients with Afib receive pacemakers or other interventions to help normalize their heartbeat, which might negate the need for anticoagulant therapy.
Are there any side effects of stopping Eliquis?
The biggest risk of stopping Eliquis is forming a blood clot, which can cause potentially life-threatening health conditions.
Otherwise, there are no side effects of stopping Eliquis, other than any side effects you had while taking Eliquis gradually dissipating.
You should watch out for signs of a blood clot if you stop Eliquis and notify your healthcare immediately if you experience:
- Swelling
- Pain
- Tenderness
- Redness of the skin
- Difficulty breathing
- Faster than normal or irregular heartbeat
- Chest pain or discomfort, which usually worsens with a deep breath or coughing
- Coughing up blood
- Very low blood pressure, lightheadedness, or fainting
Stopping Eliquis safely
If you need to stop Eliquis, you should only do so under the guidance of your healthcare provider.
Stopping Eliquis without consulting your healthcare provider puts you at risk of developing a blood clot.
Your healthcare provider can offer guidance and might suggest gradually decreasing your Eliquis dose before starting a new anticoagulant, if necessary.
Conclusion
Eliquis is an anticoagulant medication that works by blocking the Xa clotting factor. It’s FDA-approved to reduce the risk of forming dangerous blood clots, especially in patients with atrial fibrillation (an abnormal heart rhythm that can increase the risk of blood clots).
Some of the pharmaceutical alternatives to Eliquis include Pradaxa, Xarelto, Savaysa, Coumadin, and Heparin.
Some natural anticoagulants include vitamin D, salicylates, and vitamin E.
Explore More
What Foods To Eat And Avoid While Taking Eliquis (Apixaban).
