Eliquis, also known by its generic name apixaban, is one of a new generation of anticoagulant medications that recently entered the market within a few years of each other.

Like many drugs, Eliquis has its own set of side effects that can determine whether or not Eliquis is the right choice for any particular patient.

Eliquis is approved by the FDA to reduce the risk of stroke and systemic embolism in patients who have nonvalvular atrial fibrillation. It’s also approved as a treatment and preventative for pulmonary embolism and deep vein thrombosis.

As with other anticoagulants, premature discontinuation of Eliquis can put a patient at an increased risk for thrombotic events, such as stroke.

In clinical trials involving atrial fibrillation patients, an increased risk of stroke was observed in patients as they transitioned from Eliquis to warfarin.

Eliquis can also increase the likelihood of developing a hematoma for patients who receive anesthesia through a spinal or epidural puncture. Hematomas that develop near the spinal cord may lead to long-term or permanent paralysis.

Other, less common Eliquis side effects can include:

• bruising
• nausea, vomiting or constipation
• dizziness
• headache
• confusion or decreased alertness
• feeling unusually tired or weak
• shortness of breath
• difficulty swallowing
• a faster heartbeat than normal
• swelling, puffiness or redness in the eyes

Bleeding While on Eliquis

The Eliquis side effect that probably gets the most attention is its tendency to cause internal bleeding. All anticoagulants come with some risk of internal bleeding; that risk is a natural consequence of how these drugs work. The same action that prevents dangerous blood clots from forming also prevents the body from keeping bleeding under control when it does happen.

A significant factor in the bleeding risk associated with Eliquis and the other new anticoagulants has been their lack of an antidote. When these drugs were first made available and for a few years afterward, there was no complimentary medication available that would counter their anticoagulant effects.

This factor made bleeding while on anticoagulants even more dangerous, and it complicated the prospects of patients who may need to undergo surgery while taking anticoagulants.

This lack of an antidote has allowed warfarin to maintain at least one advantage over the new drugs. Warfarin’s anticoagulant effect can be counteracted by administering vitamin K.

Recently, Portola Pharmaceuticals, a small pharmaceutical company, has developed a drug called andexanet alfa for use as an bleeding antidote to Eliquis. The company applied for FDA approval for that drug in December 2015.

Eliquis Lawsuits

Excessive bleeding has been the subject at least one Eliquis lawsuit brought against the drugs manufacturers Pfizer and Bristol-Myers Squibb. This lawsuit claims the manufacturers improperly failed to warn patients and their doctors about the lack of an antidote for Eliquis bleeding.

Plaintiffs in this claim have also taken issue with the clinical studies used to support the manufacturers’ application for FDA approval for Eliquis. They say the researchers in some of these studies purposely avoided reporting some Eliquis side effects. They also allege the researchers changed and falsified records and failed to report at least one death that occurred during the study.