What Type of Pain Medication Is Safe with Eliquis?

Eliquis is usually given to people at risk for developing blood clots from conditions, such as abnormal heart rhythms. Eliquis is an anticoagulant (i.e. ‘blood thinner) used for the prevention of stroke, deep vein thrombosis and pulmonary embolism. It is a good alternative to warfarin (a commonly used blood thinner) as it typically has a more consistent effect and doesn’t require INR monitoring (a coagulation test), making a more convenient option for many.

Studies of Elqiuis show that the most common adverse events were related to bleeding. Many of the bleeding events were minor but there is the risk of more serious events such GI bleeds and major hemorrhage. Due to this, you want to avoid concurrent use of medication that further thins the blood.

How do different medications interact with Eliquis?

Use of this lifesaving medication requires caution with other drugs, especially painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs), such as nurofen, Panadol, paracetamol and aspirin. Although plenty of people take the risk to relieve aches and pains.

One-quarter of these major bleeds happen within eight days of taking an NSAID but some bleeds may happen with a single dose. The risk of bleeding is higher for people atrial fibrillation, who take a blood thinner and use an NSAID.

Patients who use blood thinners such as Eliquis should not take them. If you are taking an NSAID while taking an anticoagulant, your risk of a major bleed is double what it would be if you weren’t taking an NSAID.

What Type of Pain Medication Is Safe with Eliquis

Nurofen (Ibuprofen) and Eliquis Interaction.

Ibuprofen (brand names Nurofen, Advil, Motrin) is classified as an NSAID (non-steroidal anti-inflammatory drug). It is well known that NSAIDs inhibit blood platelet aggregation and can increase bleeding time. While this typically isn’t an issue with short time use, if NSAIDs are combined with blood thinners, the risk greatly increases.

You should not take nurofen with Eliquis. Taking the combination is known to increase the risk of bleeding episodes.

Additionally, one of the negative aspects of Eliquis is the fact that the blood thinning effect of the drug is not easily reversed. If uncontrolled bleeding occurs as a result of a medication interaction, there is no established way to reverse the anticoagulant effect of Eliquis. 

Is Nurofen (Ibuprofen) safe with eliquis?

Due to the potential of serious bleeding events, you should not take Eliquis with any other medication that thins the blood, which includes nurofen ibuprofen. There are many alternative pain medications you can take in place of ibuprofen such as Tylenol (acetaminophen).

Panadol and Eliquis

Is Panadol safe with eliquis?

Panadol is recommended as a first-line analgesic and antipyretic therapy in patients receiving short- and long-term oral anticoagulation. However, there is an increased INR level in patients treated with eliquis and panadol given at the maximum recommended dose of 4g per day.

Paracetamol and Eliquis Interaction

Is paracetamol safe with eliquis?

Using paracetamol together with eliquis is generally considered safe. However, the risk for bleeding may increase if higher dosages of acetaminophen (more than 1300 mg/day) are used for more than a few days at a time, especially in individuals who are elderly, consume alcohol regularly, or have poor nutrition. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring of your INR to safely use both medications.

Aspirine and Eliquis Interaction

Using Eliquis together with aspirin may increase the risk of bleeding, including severe and sometimes fatal haemorrhage.

Is aspirine safe with Eliquis?

The absolute risk for a major bleeding episode for a patient taking aspirine and Eliquis is nearly double that of a patient not on aspirin. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; light-headedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness.

Conclusion

If you’re taking a blood thinner, your options for pain relief are limited. When the pain is excruciating and painkillers are the only option, especially when you’ve tried everything and when the pain won’t go away, talk to a specialist. When painkillers are needed, it’s best to use the lowest dose that reduces symptoms and to stop taking them if the symptoms subside. Always make sure you talk to your doctor before mixing any type of painkiller with a blood thinner.

For patients taking another form of NSAID plus a blood thinner, there was triple the risk compared to those taking the blood thinner alone.

Most doctors warn that if you’re taking a blood thinner, do not take an NSAID. If you have a headache or aching muscles or joints, take generic Tylenol (acetaminophen).

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