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What are the side effects of Eliquis in the elderly

Side effects of Eliquis in the elderly include persistent bleeding, anemia, nausea, and bruising easily
Ashley Broadwater, writer for SingleCare
By | Mar. 11, 2025 Medically reviewed by Samantha Marr, DNP, APN, AGPCNP-BC, CCRN
An older woman reviewing medication instructions: What are the side effects of Eliquis in the elderly?

Key takeaways

  • Eliquis (apixaban) is an oral anticoagulant prescribed to prevent and treat blood clots caused by various medical conditions.

  • The most common side effects of Eliquis in seniors are bruising easily, persistent bleeding, nausea, and anemia.

  • Some medications, supplements, and other items should not be consumed with Eliquis, so get medical advice before taking the blood thinner.

  • Healthcare professionals may order a blood test before prescribing the medication to ensure the patient gets the correct dose.

  • Seek medical attention ASAP if you or a loved one experience any potentially life-threatening symptoms after taking Eliquis, such as serious bleeding or an allergic reaction. The latter might look like hives, itching, chest pain, or trouble breathing.

In this article:

Eliquis (apixaban) is an anticoagulant (blood thinner) and a brand-name drug approved by the Food and Drug Administration (FDA). As a factor Xa inhibitor, it blocks the Factor Xa protein, which contributes to blood clots. Other anticoagulants include Jantoven and Coumadin (warfarin), heparin, and Xarelto (rivaroxaban). 

While helpful, Eliquis can have side effects in seniors, such as persistent bleeding, bruising easily, anemia, and nausea.

Why are blood thinners prescribed to seniors?

This medicine is prescribed to prevent and treat blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism), as well as reduce the risk of stroke and clots in people with atrial fibrillation. 

Eliquis is also prescribed after certain procedures. For example, a medical professional may prescribe blood thinners to older adults after knee replacement surgery. Additionally, some patients may need a blood thinner after a bioprosthetic heart valve replacement (though more data is needed), according to a 2021 study in the Journal of Pharmacy Technology.

What are the side effects of Eliquis in the elderly?

Like any medication, Eliquis can have side effects. In particular, Eliquis can cause uncontrolled bleeding because it thins the blood, as well as these most common side effects of Eliquis:

  • Bruising easily
  • Persistent bleeding, even with minor cuts
  • Nausea
  • Anemia, or having low levels of healthy red blood cells, which can also cause fatigue

Gastrointestinal bleeding is another common (and invisible) concern in seniors, says Dr. Rohit Vuppuluri, MD, a double-board certified interventional cardiologist at Chicago Heart and Vascular Specialists. 

But again, an increased risk of bleeding is the biggest concern. 

“Senior citizens may be more prone to getting cuts, bumps, and bruises, and they may notice that their bleeding takes longer to stop,” says Dr. Cheng-Han Chen, MD, a board-certified interventional cardiologist and medical director of the structural heart program at MemorialCare Saddleback Medical Center in Laguna Hills, California. 

Serious side effects of Eliquis include: 

  • Severe headaches
  • Dizziness
  • Muscle weakness
  • Joint pain
  • Severe, uncontrollable, or unusual bleeding (with bleeding gums, nosebleeds, etc)
  • Thrombocytopenia, or low platelet levels
  • Coughing up blood
  • Vomiting blood or vomit that looks like coffee grounds
  • Red or black tarry stool
  • Pink, red, or brown urine
  • Hypersensitivity reactions
  • Hypotension, or low blood pressure
  • Fainting
  • Spinal or epidural blood clots 
  • Increased risk of blood clots or stroke if Eliquis is discontinued abruptly
  • Increased risk of a hematoma in rare cases

Eliquis side effects shouldn’t last longer than 48 hours, according to Dr. Vuppuluri.

Dr. Chen agrees it should clear from the body within roughly two to three days, meaning users should stop experiencing side effects afterward. 

At the same time, given those serious side effects, he prescribes this medication to seniors with caution. “We especially worry about people who may be prone to falling, and in this population, we may advise against taking a blood thinner such as Eliquis,” he says. “In many circumstances, I lower the dose of the medication in an elderly patient or even recommend stopping it altogether.”

Some people should not take Eliquis at all, such as those with antiphospholipid syndrome, due to the increased risk of blood clots.

Drugs that interact with Eliquis include aspirin, other anti-clotting medications, and inhibitors and inducers of CYP3A4. Additionally, there’s a higher risk of internal bleeding if the patient is also taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, or with concomitant use of selective serotonin reuptake inhibitors (SSRIs).

Patients should avoid taking some supplements, vitamins, and herbs while on Eliquis, too. For example, St. John’s Wort, vitamin E, and possibly ginseng can weaken the effects of Eliquis, increase the risk of bleeding problems, or interact with blood thinners. Additionally, large doses of vitamin K can make the medicine less effective.

Last but not least, alcohol does not mix well with blood thinners; it can increase bleeding risk.

How to take Eliquis

A prescribing provider will set the specific Eliquis dosage for each patient. The tablet can be taken with or without food and can be crushed (with the provider’s instructions) if the patient has trouble swallowing the medication. 

Since Eliquis has a half-life of 12 hours, it needs to be taken twice daily—once in the morning and once at night, Dr. Vuppuluri says. 

Side note: The half-life may be slightly longer for senior citizens. “Patients over the age of 75 years old may metabolize Eliquis slower,” Dr. Vuppuluri says. “Elderly patients with decreased body weight and renal function are also at risk of slower metabolizing of Eliquis.”

In fact, it “may be up to twice as long in a senior citizen compared to a younger person,” according to Dr. Chen. He explains that people’s kidneys and liver may not be able to process medications as efficiently as they age.

While Eliquis doesn’t require people to avoid any foods, certain foods (such as high-fat foods) and caffeine may exacerbate health problems that contributed to the need for Eliquis in the first place, such as heart conditions. 

Eliquis can be stopped (and needs to be sometimes, like before surgery), but with caution. “The risk of stopping Eliquis is that [the user] will no longer have the blood-thinning effect that the Eliquis was originally prescribed for,” Dr. Chen says. “Depending on the original reason for Eliquis, they may then be at an increased risk for developing a blood clot.”

Both doctors urge patients to discuss stopping Eliquis with a healthcare provider before actually doing so.

What is the safest blood thinner?

Drug name Drug class Standard dosage in seniors (ages 65 and older) Common side effects in seniors SingleCare savings
Eliquis Anticoagulant 2.5 mg to 10 mg, twice a day Bruising, persistent bleeding, nausea, anemia Get coupon
Jantoven Anticoagulant 5 mg daily (but dependent) for most adults Bleeding problems, nausea/vomiting, fatigue, headache Get coupon
Heparin Anticoagulant A loading dose of 5,000 units, followed by 20,000 to 30,000 units over 24 hours, for the average adult patient Easily bruising, uncontrolled bleeding, allergic reactions Get coupon
Xarelto Anticoagulant 2.5 mg to 20 mg, once or twice a day Minor bleeding, fatigue, dizziness Get coupon

Eliquis may be safer than Xarelto, at least regarding a lower risk of bleeding.

You can purchase Eliquis at a lower cost with a SingleCare prescription discount card.

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