Can you take Eliquis less than 12 hours apart?

In this article:

• Standard Eliquis dosage guidelines
• Can you take Eliquis less than 12 hours apart?
• Why timing matters with Eliquis
• What to do if you miss a dose of Eliquis
• Eliquis precautions in high-risk patients

In this article

• Standard Eliquis dosage guidelines
• Can you take Eliquis less than 12 hours apart?
• Why timing matters with Eliquis
• What to do if you miss a dose of Eliquis
• Eliquis precautions in high-risk patients

Eliquis (apixaban) is a commonly prescribed anticoagulant, or blood thinner. It’s used to reduce the risk of stroke and blood clots in people with atrial fibrillation (AFib), deep vein thrombosis (DVT), or pulmonary embolism (PE). Eliquis is also commonly prescribed after hip or knee replacement surgeries to prevent blood clots. Like other anticoagulants, the timing of each dose of Eliquis matters. Taking the medication too close together or too far apart affects how it works and increases your risk of side effects. Learn why consistency is important when taking Eliquis and what the experts say about how to take this medication safely.

Standard Eliquis dosage guidelines

The standard dosing schedule of Eliquis is typically one pill taken orally twice a day, 12 hours apart. Following the dosage guidelines carefully helps to keep a consistent level of medication in the blood. Taking too much Eliquis increases the risk of uncontrolled bleeding, and too little increases the risk of blood clots. 

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Can you take Eliquis less than 12 hours apart?

It’s not recommended to take Eliquis pills less than 12 hours apart. Taking your dose of Eliquis sooner than 12 hours can increase the risk of bleeding. 

There’s a risk of serious, uncontrolled, and potentially fatal bleeding with taking Eliquis, especially if someone is taking other medications that increase the risk of bleeding. Examples include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS, such as ibuprofen), selective serotonin reuptake inhibitors (SSRIs, such as fluoxetine), and other blood thinners (e.g., warfarin). 

If you overdose on Eliquis, contact your healthcare provider or hematologist. There are ways to reverse the effects of taking too much Eliquis. For example, Andexxa (andexanet alfa) is a drug used to reverse the effects of medications like Eliquis, and activated charcoal can also be used to interfere with the absorption of the drug. 

Why timing matters with Eliquis

Timing is important when taking Eliquis because it can mean the difference between effectively decreasing the risk of blood clots and stroke or experiencing side effects of the medication. 

The half-life of Eliquis is about 12 hours. This means that after 12 hours, half the initial amount of Eliquis is still in the blood. Skipping doses or stopping Eliquis suddenly decreases the amount of drug in the blood, which increases the risk of stroke and blood clots. 

Taking Eliquis less than 12 hours from the last dose can cause higher than intended levels of the drug in the blood, which can increase the risk of bleeding. Bleeding can happen in the brain, causing a hemorrhagic stroke, or in the gastrointestinal system, causing blood in the stool. It’s important to recognize these serious side effects of Eliquis:

• Coughing blood
• Bleeding gums or nosebleeds
• Low blood pressure
• Fainting
• Red or black tarry stool
• Pink, red, or brown urine

If you notice any of the above side effects of uncontrolled bleeding or blood clots, call your healthcare provider right away or go to an emergency room. Note when you took the last Eliquis pill and the pill strength. 

What to do if you miss a dose of Eliquis

If you miss a dose of Eliquis, you should take your next dose as soon as you can on the same day. Then, resume the 12-hour dosing from then. The drug’s prescribing information advises not to double up on doses if you’ve missed a dose.

If you’ve missed your Eliquis dose within six to eight hours of your scheduled dose, you should take your dose as soon as you remember it. If you’ve missed your dose by more than eight hours and it’s almost time for your next scheduled dose, then skip the missed dose and take your next dose at your usual time. 

Eliquis precautions in high-risk patients

Certain populations have a higher risk of bleeding on Eliquis. Gail Clifford, MD, physician and consultant at ARRC LED in Orlando, Florida, explains: “Older adults over 70, patients with kidney or liver impairment, patients with low body weight, patients on certain interacting medications (NSAIDs, SSRIs, antiplatelets), patients with a history of GI bleeding or peptic ulcer disease, and frail patients or those with frequent falls are at a higher risk of side effects with Eliquis,” she says. 

Nieca Goldberg, MD, cardiologist and Clinical Associate Professor of Medicine at NYU Grossman School of Medicine, adds that people taking aspirin, omega-3 fish oil supplements, clopidogrel, and ticagrelor are also at a higher risk of bleeding. 

Healthcare providers may modify their care for patients on Eliquis if they’re at higher risk of bleeding, over the age of 65, or have a higher risk of falls. “In these groups, doctors often adjust the dose, monitor more closely, or consider alternatives,” Dr. Clifford says.

Bottom line

Stick to a dosing schedule as best you can when taking Eliquis. Some patients find that an alarm on their wristwatch or phone can help keep them on schedule. Don’t take Eliquis doses less than 12 hours apart unless your healthcare provider tells you to do so. Taking the doses too close together or too far apart can lead to too much or too little drug in your system, which can raise the risk of bleeding or blood clots. 

See your healthcare provider if you have any unusual or prolonged bleeding, bruising, or other signs of Eliquis overdose. Dr. Goldberg also advises contacting your healthcare provider if you need to take Paxlovid for a COVID-19 infection, if you missed a dose of Eliquis and don’t know what to do, or if another healthcare provider recommends stopping Eliquis for a procedure. “Call the doctor who prescribed the Eliquis for instructions,” she says.

Call 911 or get emergency medical care if you experience signs of a stroke (e.g., face drooping on one side, arm weakness, speech difficulty), chest pain, fainting, shortness of breath, dizziness, or heavy bleeding.