Does Eliquis cause hair loss?

In this article:

• Is hair loss a side effect of Eliquis?
• Blood thinners and hair loss
• Indirect reasons for Eliquis hair loss
• How to manage Eliquis hair loss

In this article

• Is hair loss a side effect of Eliquis?
• Blood thinners and hair loss
• Indirect reasons for Eliquis hair loss
• How to manage Eliquis hair loss

Eliquis (apixaban) is a prescription blood thinner used to treat and prevent blood clots, and lower the risk of stroke in people with a type of heart condition called atrial fibrillation (AFib). Some people wonder whether they should expect an increase in hair loss while taking Eliquis, since hair loss is a side effect of some other blood thinners (also called anticoagulants). Here’s what you need to know about Eliquis and hair loss.

Is hair loss a side effect of Eliquis?

Common side effects of Eliquis include anemia, nausea, and bruising, but not hair loss (alopecia). Hair loss is also not listed as an adverse reaction in the prescribing information for Eliquis, published by the manufacturer, Bristol-Myers Squibb. 

Gurpreet Saini, MD, an internal medicine physician at MedStar Health in Maryland, says that even though hair loss hasn’t been confirmed in any of the current research into the medication, drug-related hair loss can sometimes be underreported or vary from person to person. She also notes that there are a few case reports and anecdotal patient experiences suggesting a possible link. According to an analysis published in 2020, some patients reported apixaban (the active ingredient in Eliquis and the future generic version) as a potential cause of alopecia (especially in older women), but the authors of that analysis acknowledge there isn’t enough clear or conclusive evidence to connect Eliquis directly to hair loss.

Blood thinners and hair loss

If hair loss isn’t considered a common side effect of Eliquis, why do some people worry that taking this medication will contribute to alopecia? It’s because older blood thinners, like warfarin and heparin, do have a documented association with hair loss, especially with long-term use, per Dr. Saini. She also explains that older generation anticoagulants can interfere with the hair cycle, particularly during the anagen phase when hair grows the most. As a result, an excess amount of hairs prematurely shift to the catagen, or stagnant phase, before falling out a couple of weeks later.

However, the same effects haven’t been clearly seen in people using Eliquis. “Eliquis works differently than warfarin or heparin, and doesn’t seem to have the same direct effect on hair follicles,” Dr. Saini says.

While newer blood thinners like Eliquis aren’t usually considered a common cause of hair loss, it’s not impossible. According to Melanie Palm, MD, MBA, dermatologist and cosmetic surgeon at Art of Skin MD in California, in rare cases, Eliquis can worsen a condition called telogen effluvium, a type of temporary hair shedding where more hairs shift into the resting phase of the growth cycle and eventually fall out. Telogen effluvium is usually triggered by stress, surgery, illness, or sudden dietary changes. Some people on Eliquis may see excess hair loss if they’re taking it following a major life event or change. 

RELATED: How much does Eliquis cost without insurance?

Indirect reasons for Eliquis hair loss

Experiencing hair loss while taking a medication isn’t always directly caused by the drug itself, and that’s typically the case with Eliquis. If you’re noticing hair loss on Eliquis, it’s more likely caused by the reason you’re taking the medication in the first place.

“Many people who start Eliquis or blood thinners are doing so after a major health event, [like] a cardiovascular issue, surgery, or hospitalization,” Dr. Palm says, adding that the physical and emotional stress of these events can contribute to hair loss.  

Other common causes of hair loss, per Dr. Saini, include:

• Nutritional deficiencies, especially low levels of iron, zinc, and protein 
• Coexisting health conditions, including thyroid disorders, autoimmune disorders, and hormonal changes 
• Other medications, like beta blockers, certain cholesterol-lowering drugs, and antipsychotic medications, although hair loss is an uncommon side effect of these drug classes  

Some of these other causes may have nothing to do with Eliquis or any recent health changes you’ve experienced, but there could be some confusing overlap. For example, people with atrial fibrillation are sometimes prescribed beta blockers to treat their irregular heart rate and Eliquis to lower their stroke risk. That could make it difficult to tell whether it’s the sudden heart condition, the beta blocker, or a blood thinner causing hair loss.

How to manage Eliquis hair loss 

If you’re having increased hair loss or shedding while taking Eliquis, do not stop taking your medication. Eliquis is prescribed for life-saving reasons, explains Dr. Palm, and preventing a blood clot or stroke is more important than stopping hair loss.

That said, talk to your primary care provider if you have concerns. Your hair loss may or may not be caused by Eliquis, but your healthcare provider is the best person to help you figure it out. 

“When a patient comes to me with hair loss, [we] do a comprehensive review of their history and run the right blood work,” Dr. Palm says. “We review their medications, check for nutritional deficiencies, and run blood work for thyroid disorders, vitamin D deficiencies, or anemia.”

If it seems likely that Eliquis is the cause, your provider may still recommend you stay on the medication while incorporating some other therapies to prevent and treat your hair loss. According to Dr. Palm, this might include:

• Increasing your intake of protein, vitamin D, iron, and B vitamins, which support hair growth
• Practicing gentle hair care, including reducing heat styling, harsh treatments, and products containing parabens and phthalates
• Getting the right amount of sleep to reestablish a healthy hair growth cycle
• Consulting with a dermatologist and considering the use of topical minoxidil, a hair growth treatment, or other in-office procedures like microneedling

If your provider thinks you’re experiencing telogen effluvium as a result of recent medical procedures, stress, or illness, remember that it’s temporary: “It improves once the body stabilizes,” Dr. Palm says, though she adds that it may take several months before your hair regrowth and density are back to normal.  

Ultimately, the decision to continue or change your Eliquis dose should always be made by you and your prescribing provider. There are risks and benefits to trying alternative blood thinners, per Dr. Palm, so make sure you always talk to your healthcare provider about any side effects you’re experiencing before changing your medications.  

Bottom line

Eliquis isn’t known for causing hair loss as a side effect of treatment, so there’s most likely another reason for your increased shedding, even if it’s a new medication for you. Typically, people experience hair loss while taking Eliquis for other reasons, like the physical or emotional stress of a recent surgery or health event, or a coexisting medical condition. 

“Eliquis or blood thinners may play a role [in hair loss], but it’s often one piece of a larger health puzzle,” Dr. Palm says.

If you think you’re having hair loss while taking Eliquis, talk to your healthcare provider. They can help you identify the cause and provide suggestions for treating or managing your symptoms. If it turns out that Eliquis truly is causing your hair loss, they’re also the best person to help you safely switch to an Eliquis alternative, if necessary.