Eliquis is an anticoagulant medication that lowers the risk of dangerous blood clots forming in your heart due to atrial fibrillation (AFib). AFib is the most common arrhythmia and a major risk factor for stroke, especially among older adults.

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AFib is a heart rhythm disturbance characterized by chaotic and unpredictable beating of your heart’s upper chambers (atria). The irregular beating of the atria allows blood to pool there and form blood clots that could travel to your brain and cause a stroke.

To lower the risk of stroke, doctors often prescribe anticoagulant medications, which interfere with the clotting process. Eliquis, the brand name of the anticoagulant apixaban, is a widely used AFib medication. It’s been shown to as effective and often safer than some of its counterparts.

Eliquis can bring a risk of side effects and isn’t appropriate for everyone with AFib. This article will explain more about the benefits of this “blood thinning” medication when used to lower the risk of stroke in people with AFib, and what you may want to discuss with your healthcare team.

People with AFib are four to six times more likely to have a stroke compared with their peers who don’t have the arrhythmia. Stroke risk increases with age for both people who have AFib and those who don’t.

Stroke and heart failure are two of the most serious complications of AFib. Heart failure is a risk because AFib causes your heart to work harder to pump enough blood to meet your body’s needs, weakening the heart muscle in the process.

To assess the risk of stroke for someone with AFib, clinicians often use what’s known as a CHA₂DS₂-VASc score. This is based on factors that include:

The resulting score determines if someone should be started on anticoagulation therapy, such as Eliquis.

While Eliquis doesn’t cure or treat the abnormal heart rhythm associated with AFib, it does lower the risk of blood clot formation that can occur. Small blood clots, no matter where they form in your body, often dissolve on their own and pose no serious health risk.

Larger clots can lodge in an artery and block blood flow. A clot that blocks a coronary artery may cause a heart attack. A clot that blocks blood flow in your brain or in an artery supplying blood to your brain can cause an ischemic stroke.

Anticoagulants such as Eliquis work by interfering with the process of coagulation, which is how blood solidifies in the form of a clot. They do this by preventing substances in the blood called “clotting factors” from working.

A study comparing Eliquis with other, similar anticoagulants suggests that Eliquis is as effective as other medications in lowering stroke risk. That research also shows that it’s safer than drugs such as the anticoagulants warfarin and dabigatran.

A separate study from 2021 suggests that Eliquis was associated with a lower stroke risk compared with the anticoagulant rivaroxaban.

Though Eliquis can help lower your risk of a stroke, it doesn’t guarantee that a stroke won’t occur.

As with any medication, Eliquis is most effective and least likely to cause side effects when taken as prescribed. Eliquis is usually taken as oral medication twice a day. Taking Eliquis incorrectly may increase your chances of having a stroke.

There’s also the risk of a hemorrhagic stroke, which occurs when a blood vessel in the brain leaks or ruptures.

Hemorrhagic strokes are less common than ischemic strokes, which are those caused by the blockage of blood flow in an artery supplying oxygenated blood to brain tissue.

Taking an anticoagulant such as Eliquis won’t prevent a hemorrhagic stroke and may actually make the bleeding event more serious.

The body needs some clotting ability to prevent major bleeding events. Because Eliquis makes it more difficult for your blood to clot properly, the drug may lead to bleeding side effects such as nosebleeds and bleeding gums. Vaginal bleeding and blood in your stools may also occur.

You may also notice that it takes longer for a cut or scrape to stop bleeding.

Other possible side effects include:

  • chest tightness
  • headache
  • joint pain or swelling
  • rash
  • shortness of breath or wheezing

Individuals taking Eliquis should also undergo regular monitoring of their liver and kidney function to assess any side effects that may develop.

Anticoagulants, including Eliquis, have become the cornerstones of AFib treatment since their approval by the Food and Drug Administration (FDA) in 2015.

But some people with AFib may need to take an alternative medication called warfarin (Coumadin), which also helps reduce the risk of blood clot formation and stroke.

You may not be able to take Eliquis if you:

  • are pregnant
  • drink large amounts of alcohol
  • have kidney and/or liver disease
  • have uncontrolled high blood pressure
  • have a history of bleeding complications
  • have artificial heart valves

Blood clots that form in your heart can travel to the brain and cause an ischemic stroke. Eliquis is an anticoagulant medication that lowers the risk of dangerous blood clots forming in the heart due to AFib, the most common arrhythmia and a major risk factor for stroke, especially among older adults.

Eliquis interferes with the body’s natural clotting process, but it can lead to dangerous bleeding risks. To lower your risk of side effects, talk with a doctor about your overall health and lifestyle to determine whether Eliquis is safe and appropriate for you.