Can You Mix Eliquis And Alcohol?

If you’re taking Eliquis, you might be wondering whether it’s safe to enjoy a drink now and then. While a small amount of alcohol is generally fine for most people, drinking too much can raise serious health risks. Understanding how alcohol interacts with Eliquis can help you make safer choices and avoid complications.

Is It Okay To Drink Alcohol While On Eliquis?

Eliquis (apixaban) is a prescription anticoagulant (blood thinner) used to prevent and treat blood clots. A common question from patients is: Can you drink alcohol while taking Eliquis? 

Experts say that it is best to avoid alcohol while on Eliquis. However, an occasional small drink while taking Eliquis is likely safe for most people. Heavy alcohol use, on the other hand, can worsen Eliquis’ side effects, increasing the risk of bleeding. 

What Is Eliquis?

Eliquis (apixaban) is a direct-acting oral anticoagulant (DOAC) and Factor Xa (10a) inhibitor. By blocking Factor Xa, a natural substance that is necessary for blood clot formation in the body, Eliquis makes it harder for blood clots to form. 

While Eliquis does not dissolve existing clots, it can prevent them from getting bigger.

Eliquis can be used in adults to:

• Prevent strokes in people with nonvalvular atrial fibrillation (a heart rhythm abnormality) that is not caused by a heart valve issue (valvular heart disease). 

• Prevent blood clots after hip or knee replacement surgery.  

• Treat and prevent deep vein thrombosis (DVT) (blood clot in the leg) or pulmonary embolism (PE) (blood clot in the lungs).

Eliquis can also be used in children and infants to treat and reduce the risk of blood clots in the veins after at least five days of initial anticoagulation treatment.

Potential Interactions

Certain foods and drinks can interact with Eliquis, potentially increasing the risk of adverse effects. For example, grapefruit juice and Eliquis interact, resulting in an increased concentration of the drug in the body, which can increase the risk of bleeding.

Both alcohol and Eliquis can increase the risk of bleeding. Mixing alcohol and Eliquis can therefore have an additive effect with serious health risks. 

Can You Drink Alcohol While Taking Eliquis?

The National Blood Clot Alliance recommends limiting alcohol consumption to no more than two drinks at a time if you are taking blood thinners. (One drink = one glass of wine, one beer, one cocktail, or one shot).

The American Blood Clot Association recommends that people with blood-clotting disorders be extremely cautious while drinking alcohol. The recommendation is that it is best to avoid alcohol while on Eliquis. However, an occasional small drink is probably safe for most people.

Mayo Clinic experts say alcohol can change the way blood thinners work. Patients should talk to their healthcare provider for advice on dosing and safe limits of alcohol consumption.

Risks of Combining Alcohol and Blood Thinners

Blood thinners, also known as anticoagulants, work by reducing the body’s ability to form blood clots, which is beneficial in preventing dangerous blood clots. But this also increases the risk of bleeding. 

Increased Risk of Bleeding

Alcohol also increases the risk of bleeding. Therefore, combining the two can have an additive effect, with a higher risk of serious bleeding. Even minor injuries may cause prolonged or excessive active bleeding, such as nosebleeds, bleeding gums, or heavy menstrual periods. 

If internal bleeding occurs, it is crucial to seek immediate medical attention. For instance, intracranial hemorrhages (brain bleeds) can result in neurological damage, long-term disabilities, and even death. GI bleeding (in the digestive tract) can lead to anemia, shock, infection, heart attack, respiratory distress, and death.

Liver Stress and Impaired Metabolism

Since the liver metabolizes both alcohol and Eliquis, heavy alcohol consumption while on Eliquis can increase the risk of liver injury and affect the metabolism of blood thinners, increasing the risk of bleeding.

Dizziness and Impaired Judgment

Dizziness, lightheadedness, tiredness, and lack of energy are common side effects of Eliquis. Alcohol is a central nervous system (CNS) depressant, meaning it slows down brain activity and function. 

Mixing alcohol and Eliquis can make these side effects worse and increase the risk of falls, injuries, and accidents that can cause severe bleeding.

Factors That Influence Risk

Amount of Alcohol Consumed

The risk of bleeding is higher on Eliquis if you drink alcohol in large quantities. Moderate alcohol intake (one or two drinks at a time) while on Eliquis is typically safe for most patients. However, drinking heavily can significantly increase the risk. 

Age, Gender, and Health Status

Studies have shown that older adults are at a considerably higher risk of bleeding on blood thinners compared to younger patients. 

Additionally, females process alcohol more slowly than males and are at a higher risk of complications from combining Eliquis and alcohol.

Comorbid medical conditions, such as severe liver problems, kidney disease, blood disorders, blood vessel disease, diabetes, and cancer, can increase the risk of bleeding while on blood thinners such as Eliquis.

Other Medications or Supplements

Certain medications can interact with Eliquis. This drug interaction can reduce Eliquis's effectiveness or increase the risk of serious side effects of Eliquis or the other medication. 

Potential Eliquis interactions include:

• Other blood thinners, such as heparin or warfarin (Coumadin).

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve).

• Antifungal agents such as ketoconazole and itraconazole.

• Medications for HIV (human immunodeficiency virus) infection include ritonavir.

• Antibiotics such as clarithromycin.

• Seizure medications such as carbamazepine and phenytoin.

• Dietary supplements or herbal products like St. John’s wort.

Safe Practices and When To Avoid Alcohol Entirely

When to Avoid Alcohol

People with a history of alcohol use disorder should discuss the risks of taking Eliquis and drinking alcohol with their doctor. Healthcare providers may recommend other treatment options for blood clots while addressing alcohol use disorder to lower the risk. 

Pregnant women and people who are under the legal drinking age should also avoid drinking alcohol while taking Eliquis.

Safe Drinking Tips on Eliquis

• Before starting Eliquis treatment, discuss your alcohol habits with your healthcare provider. Be honest in reporting the frequency and quantity of alcohol consumed on a daily or weekly basis.

• Limit alcohol intake.

• Alternate alcoholic drinks with water to stay hydrated and give your body time to process the alcohol.

• Eat before and while drinking to slow down alcohol absorption.

• Be aware of hidden alcohol in mixers and other beverages. Check labels for alcohol content.

• Monitor for any signs of bleeding. Seek emergency medical attention for the following:

• Nosebleeds

• Bleeding gums

• Coughing up blood

• Vomiting blood

• Vomit that looks like coffee grounds

• Heavy vaginal bleeding

• Pink, red, or brown urine

• Blood in stool

• Black, tarry stools

Frequently Asked Questions

Can You Drink Coffee With Eliquis?

Yes, you can drink coffee with Eliquis. Caffeine generally does not interact with Eliquis. However, please consult your doctor or pharmacist for more personalized advice.

Is Eliquis Hard On The Liver?

Eliquis (apixaban) can cause a low rate of elevations in liver enzymes and rare cases of clinically significant liver injury.