Eliquis Interactions: Alcohol, Medications, and Others

Eliquis (apixaban) is a prescription drug that treats certain kinds of blood clots, including pulmonary embolism and deep vein thrombosis. This drug can interact with some foods and supplements. For example, Eliquis can interact with grapefruit and St. John’s wort.

An interaction occurs when one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about the possible interactions of Eliquis. And for more information about Eliquis, including details about its uses, see this article.

Certain health conditions or other factors could increase your risk of harm if you take Eliquis. In such cases, your doctor may not prescribe Eliquis for you. These are known as contraindications. The list below includes contraindications of Eliquis.

If you have active bleeding. You should not take Eliquis if you have any bleeding occurring, including bleeding inside your body. An example is gastrointestinal bleeding (bleeding in the stomach or intestines). Eliquis increases your risk of bleeding. Using Eliquis could worsen bleeding that’s already happening.

If you’ve had an allergic reaction. Your doctor likely won’t prescribe Eliquis if you’ve had an allergic reaction to the drug or any of its ingredients. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Eliquis, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Eliquis is safe for you to take.

Eliquis and alcohol aren’t known to interact with each other.

But both Eliquis and alcohol make it harder for your blood to form clots. So drinking alcohol while you’re taking Eliquis could increase your risk of bleeding.

If you drink alcohol, talk with your doctor about how much, if any, is safe to consume during Eliquis treatment.

Before you start taking Eliquis, tell your doctor and pharmacist about any prescription, over the counter (OTC), or other drugs you take. Sharing this information with them may help prevent possible interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The chart below lists drugs that may interact with Eliquis. Keep in mind that this chart does not include all drugs that may interact with Eliquis. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug name	Drug examples	Interaction result with Eliquis
nonsteroidal anti-inflammatory drugs (NSAIDs)	• aspirin • ibuprofen (Advil) • naproxen (Aleve, Naprosyn) • meloxicam (Mobic) • celecoxib (Celebrex)	can increase the risk of side effects from Eliquis
anticoagulants	• rivaroxaban (Xarelto) • warfarin (Jantoven) • heparin • dabigatran (Pradaxa)	can increase the risk of side effects from Eliquis, as well as the other anticoagulants
certain antiepileptic drugs	• carbamazepine (Tegretol) • phenytoin (Dilantin)	can make Eliquis less effective than usual
certain antifungal drugs	• ketoconazole • itraconazole (Sporanox, Tolsura)	can increase the risk of side effects from Eliquis
any treatment that includes ritonavir	• ritonavir (Norvir) • ritonavir and lopinavir (Kaletra) • ritonavir and nirmatrelvir (Paxlovid)	can increase the risk of side effects from Eliquis
methyltestosterone (Methitest)	—	can increase the effect of Eliquis
rifampin (Rifadin)	—	can make Eliquis less effective than usual

Learn more about certain drug interactions that can occur with Eliquis.

Interaction with nonsteroidal anti-inflammatory drugs

NSAIDs are used to relieve pain. Eliquis can interact with nonsteroidal anti-inflammatory drugs (NSAIDs) as described in the table below.

What could happen	Examples of NSAIDs	What you can do
can increase the risk of bleeding, including severe bleeding	• aspirin • ibuprofen (Advil) • celecoxib (Celebrex) • naproxen (Aleve) • meloxicam (Mobic)	Ask your doctor if it’s safe for you to take an NSAID with Eliquis. They may recommend that you avoid taking these drugs together.

Interaction with methyltestosterone

Methyltestosterone (Methitest) is a drug used to treat low testosterone and certain kinds of breast cancer in females.* Eliquis can interact with methyltestosterone as described in the table below.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

What could happen	What you can do
can increase the effect of Eliquis and increase your risk of bleeding	If you take methyltestosterone and Eliquis together, tell your doctor. They’ll closely monitor you for signs of bleeding.

Interaction with other anticoagulants

Eliquis belongs to a group of drugs called anticoagulants, also known as blood thinners. It can interact with other anticoagulant medications as described in the table below.

What could happen	Examples of other anticoagulants	What you can do
can increase the effect of Eliquis and increase your risk of bleeding	• rivaroxaban (Xarelto) • warfarin (Jantoven) • heparin • dabigatran (Pradaxa)	Before you start taking Eliquis, tell your doctor it you’re already taking an anticoagulant. Due to this risk, doctors will not prescribe Eliquis and another anticoagulant together.

Does Eliquis interact with supplements?

Before you start taking Eliquis, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Eliquis interactions with herbs

Eliquis can interact with the herb St. John’s wort. Specifically, St. John’s wort can make Eliquis less effective. Due to this risk, doctors will recommend that you do not take St. John’s wort and Eliquis together.

If you take St. John’s wort and want to continue doing so, talk with your doctor. They may suggest a medication other than Eliquis as a better choice for your condition.

Eliquis and vitamins

There are currently no reports of Eliquis interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Eliquis treatment.

Does Eliquis interact with food?

Eliquis can interact with grapefruit. Specifically, grapefruit can increase the risk of side effects from Eliquis, particularly bleeding.

It’s recommended that you avoid consuming grapefruit and any grapefruit products while taking Eliquis. But if you consume grapefruit regularly and want to continue doing so, your doctor may lower your dosage of Eliquis.

Does Eliquis interact with vaccines?

Eliquis isn’t known to interact with any vaccines.

If you need a vaccine, tell your doctor or pharmacist what medications you take. They can let you know whether it’s safe to get the vaccine.

Does Eliquis interact with lab tests?

Eliquis isn’t known to interact with any lab tests.

If you’re concerned about your medications interacting with any lab tests you have, talk with your doctor.

Does Eliquis interact with cannabis or CBD?

There are currently no reports of Eliquis interacting with cannabis (commonly referred to as marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Eliquis.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may increase the risk of interactions with Eliquis. Before taking Eliquis, talk with your doctor about your health history. They’ll determine whether Eliquis is right for you.

Health conditions or other factors that might interact with Eliquis include:

Active bleeding. You should not take Eliquis if you have any bleeding occurring. For more information, see the “When to avoid Eliquis” section above.
Antiphospholipid syndrome (APS). Eliquis can increase the risk of blood clots in people with APS. If you have this syndrome, your doctor will likely not prescribe Eliquis for you. They’ll discuss treatments that are safer than Eliquis.
Kidney problems. Your body depends on your kidneys to rid itself of Eliquis after you take a dose. If you have kidney problems, such as chronic kidney disease, Eliquis levels may build up in your body. This can increase your risk of side effects. Depending on your kidney health and other factors, your doctor may prescribe a lower Eliquis dose.
Severe liver problems. It’s not known whether Eliquis is safe or effective in people with severe liver problems, such as severe cirrhosis. If you have a liver problem, tell your doctor before you start taking Eliquis. They can discuss with you whether Eliquis is a good treatment option based on your liver health.
Pregnancy. It’s not known whether it’s safe to take Eliquis while pregnant. If you’re pregnant or planning to become pregnant, talk with your doctor about the possible treatment options for your condition.
Breastfeeding. It’s not known whether it’s safe to breastfeed while taking Eliquis. If you’re breastfeeding or planning to do so, talk with your doctor. They can discuss with you the treatment options that may be safe while breastfeeding your child.
Allergic reaction. If you’ve had an allergic reaction to Eliquis or any of its ingredients, your doctor will likely not prescribe Eliquis. You can ask them about other treatments that may be better choices for you.

Find answers to some frequently asked questions about Eliquis and possible interactions.

Does Tylenol (acetaminophen) interact with Eliquis?

No, Tylenol and Eliquis aren’t known to interact with each other.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can interact with Eliquis, increasing your risk of bleeding. NSAIDs are a kind of pain-relieving medication. Examples include ibuprofen (Advil) and naproxen (Aleve). Tylenol is not an NSAID.

NSAIDs and Tylenol are commonly used to treat the same conditions, such as headache or muscle pains. But unlike NSAIDs, Tylenol is believed to be safe to take with Eliquis.

Is it safe to take amoxicillin and Eliquis together?

Yes, amoxicillin and Eliquis are safe to take together.

Amoxicillin is an antibiotic used to treat certain infections. Amoxicillin itself doesn’t interact with Eliquis.

But amoxicillin is sometimes prescribed with other antibiotics that can interact with Eliquis. For example, it may be prescribed with the drugs clarithromycin and lansoprazole (Prevacid) to treat H. pylori bacterial infections. The antibiotic clarithromycin may interact with Eliquis.

If you’re prescribed amoxicillin alone, it’s safe to take it with Eliquis. But if you need treatment that requires more than one antibiotic, let your doctor know you’re taking Eliquis. They may avoid prescribing an antibiotic that interacts with Eliquis. Or they may temporarily lower your Eliquis dose until your infection clears and you stop taking the antibiotic.

Can I take doxycycline with Eliquis?

Yes, you may take doxycycline (Vibramycin, Doryx) with Eliquis. There’s no known interaction between doxycycline and Eliquis.

Doxycycline is an antibiotic used to treat certain infections. While Eliquis does not interact with this drug, it may interact with other antibiotics. If you have questions about antibiotics that interact with Eliquis, ask your doctor or pharmacist.

Is it safe to have testosterone injections while taking Eliquis?

Yes, it should be safe. There is no known interaction between testosterone injections and Eliquis.

Testosterone injections are used to treat low testosterone and certain kinds of breast cancer in females.* If your doctor prescribes testosterone injections for you, they’ll also likely have you continue taking Eliquis.

Eliquis can interact with methyltestosterone (Methitest), which comes in forms that you take by mouth. But Eliquis isn’t known to interact with testosterone injections.

If you have questions about testosterone interactions with Eliquis, ask your doctor or pharmacist.

* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Is it safe to take a zinc supplement while I’m taking Eliquis?

Zinc is not thought to interact with Eliquis.

But before taking a zinc supplement, be sure to talk with your doctor or pharmacist. They can check whether zinc interacts with other medications you may take or medical conditions you may have.

Taking certain steps can help you avoid interactions with Eliquis. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

Whether you drink alcohol or use cannabis.
Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list .
What to do if you start taking a new drug during Eliquis treatment.

It’s also important to read Eliquis’ label and other paperwork that comes with the drug. You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called the prescribing information ) may have other details about interactions. If you need help understanding this information, talk with your doctor or pharmacist.

Taking Eliquis exactly as prescribed can also help prevent interactions.

If you still have questions about Eliquis and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

Will my dosage of Eliquis affect my risk of interactions?
If Eliquis interacts with a health condition I have, is it still safe for me to take?
If I have a headache while taking Eliquis, are there medications I can take to treat it that don’t interact with Eliquis?
What should I do if I start taking a new medication or supplement while I’m taking Eliquis?

To learn more about Eliquis, see these articles:

Eliquis (apixaban)
Eliquis and Cost: What You Need to Know
Side Effects of Eliquis: What You Need to Know
Xarelto vs. Eliquis: What You Should Know

To get information on different conditions and tips for improving your health, subscribe to any of Austra Health’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Austra Health has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Last medically reviewed on April 6, 2023