Eliquis internal bleeding may create a basis for a new wave of product liability lawsuits, as has happened with two similar anticoagulant medications.

Eliquis, also known as apixaban, is an anticoagulant, or blood-thinning medication. It’s manufactured and marketed through a collaborative effort between Pfizer Inc. and Bristol-Myers Squibb Co.

Eliquis was first approved by the FDA in December 2012 as a treatment to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Since then, the FDA has also approved it to prevent blood clots and deep vein thrombosis following hip or knee surgery and to treat pulmonary embolism and deep vein thrombosis.

Eliquis is the third of three anticoagulant medications that began to enter the market in 2010, the other two being Pradaxa (dabigatran) and Xarelto (rivaroxaban). This new generation of medications was developed to compete with warfarin (sold as Coumadin), the dominant anticoagulant medication for over 50 years.

As with all anticoagulant medications, Eliquis increases the risk of excessive bleeding, sometimes to a degree that is life-threatening. Simultaneous use of Eliquis with certain other drugs – aspirin, nonsteroidal anti-inflammatory drugs, other anticoagulants, heparin, selective serotonin reuptake inhibitors, and serotonin norepinephrine reuptake inhibitors – can increase the risk of bleeding even more.

Eliquis, as well as the other two new anticoagulants, have one distinct disadvantage compared to warfarin in that they have no antidote, or “reversal agent.” When warfarin causes excessive bleeding, that bleeding can be slowed by administering vitamin K.

There is no such antidote for Eliquis bleeding. In fact, there is no specific way, via mediation or otherwise, to reverse Eliquis bleeding once it starts, other than by discontinuing the drug – whose anticoagulant effect continues for at least 24 hours. Sudden cessation of Eliquis treatment can increase the risk of stroke.

Cases of excessive bleeding associated with new anticoagulants like Eliquis spawned a wave of products liability lawsuits against the drugs’ manufacturers. Thousands of federal Pradaxa lawsuits against Boehringer Ingelheim have been consolidated into a multidistrict litigation, or MDL, pending in U.S. District Court for the Southern District of Illinois. In May 2014, Boehringer Ingelheim agreed to pay $650 million to settle all pending claims.

Similarly, the manufacturers of Xarelto are defending themselves in a MDL over Xarelto bleeding. That MDL began in December 2014 with the transfer of 21 federal Xarelto bleeding lawsuits to the U.S. District Court for the Eastern District of Louisiana. Another MDL of Pennsylvania state Xarelto lawsuits is pending in Philadelphia.

The increased risk of bleeding caused by these new anticoagulants is a common theme of these lawsuits. The plaintiffs have typically suffered one or more instances of serious bleeding, some requiring hospitalizations and blood transfusions. Some cases also have resulted in death, in which case the victim’s family may be in a position to bring a wrongful death lawsuit.

Plaintiffs typically allege the drug’s manufacturers failed to properly warn them or their physicians that these new anticoagulants increase the risk of excessive bleeding, or that there is no reversal agent for such bleeding. In such cases, compensation may be available for physical injuries, pain and suffering, lost wages, and medical bills.

Some plaintiffs who allege the manufacturer’s actions were knowing or intentional are also seeking punitive damages.