Can you take ibuprofen with Eliquis?

In this article:

• Can you take Eliquis and ibuprofen together?
• What pain reliever can you take with Eliquis?
• Compare pain relievers
• Natural pain relief on Eliquis

In this article

• Can you take Eliquis and ibuprofen together?
• What pain reliever can you take with Eliquis?
• Compare pain relievers
• Natural pain relief on Eliquis

People may commonly reach for ibuprofen when looking for pain relief, but managing pain while taking blood thinners requires careful medical guidance. Eliquis (apixaban) is a prescription anticoagulant medication. It thins the blood to prevent blood clots and reduce the risk of stroke. Ibuprofen is an over-the-counter (OTC) anti-inflammatory medication used to treat pain or fever. Ibuprofen belongs to a class of pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs) that may affect blood clotting. 

We consulted leading cardiologists and medical experts about their recommended approaches to managing pain safely while taking Eliquis and whether it is safe to take ibuprofen during Eliquis treatment.

Can you take Eliquis and ibuprofen together?

It’s generally not recommended to take Eliquis and ibuprofen together because the combination increases the risk of bleeding. According to its drug label, Eliquis interacts with NSAIDs such as aspirin, ibuprofen, and naproxen. NSAIDs can affect blood clotting by interfering with a key enzyme called platelet cyclooxygenase, which results in slower blood clotting and a higher risk of bleeding. 

“Sometimes, short courses (less than two weeks) of low-dose ibuprofen can be appropriate for management of acute inflammatory issues,” says Christopher Norman, board-certified geriatric nurse practitioner and advanced practice holistic nurse in central New York. Although low-dose ibuprofen is available over the counter, Norman still advises calling a healthcare provider for guidance before starting the ibuprofen.

The potential benefits of taking ibuprofen for pain relief or fever relief should be carefully weighed against the increased bleeding risk. “When a patient taking Eliquis inquires about using ibuprofen, my primary concern is their safety. Both Eliquis and ibuprofen increase the risk of bleeding, so it’s essential to assess their overall health and medical history,” says Pamela Tambini, internal medicine physician and medical director at Engage Wellness in Acton, Massachusetts. 

This risk isn’t limited to obvious bleeding like nosebleeds or bruising; it includes the possibility of gastrointestinal (GI) bleeding or other forms of internal bleeding that can have serious or life-threatening side effects. A study published in 2019 suggested people who started taking NSAIDs with blood thinners such as Eliquis and warfarin had an increased risk of internal bleeding. 

Taking ibuprofen with Eliquis specifically may increase the risk of GI bleeding. Norman adds, “If you have a history of GI bleeding, I would avoid even a short course of ibuprofen unless your healthcare provider authorizes it.” Ask your healthcare provider whether taking Eliquis and ibuprofen is appropriate for you. 

What pain reliever can you take with Eliquis?

Although many OTC pain relievers, such as naproxen and aspirin, are NSAIDs, Tylenol (acetaminophen) is considered safe to take with Eliquis. Unlike ibuprofen, acetaminophen doesn’t affect blood clotting and can be used to manage pain and fever. “For patients taking Eliquis, I typically recommend acetaminophen as my first choice for managing most types of pain because it does not significantly increase the risk of bleeding,” Dr. Tambini says. 

Dr. Tambini also shares that she sometimes recommends topical NSAIDs like diclofenac gel for localized pain because they can be effective and carry fewer side effects and interactions than oral NSAIDs. Oral diclofenac is not considered safe to take with Eliquis.

Muscle relaxants and anticonvulsant medications are some prescription options for pain management that can be taken with Eliquis. Talk to your healthcare provider to see which options would be right for you. 

Watch for signs that could indicate a dangerous drug interaction with Eliquis. Seek medical attention if you notice the following symptoms of excessive bleeding: 

• Bloody pink, red, or brown-colored urine
• Bloody red or black tarry-colored stool
• Vomit that looks like coffee grounds or has blood in it 
• Coughing up blood 
• Prolonged bleeding from cuts or nosebleeds (longer than 10 minutes)
• Severe headaches 

RELATED: Eliquis side effects and how to avoid them

Compare pain relievers

Drug name	Drug class	Safe to take with Eliquis? (Yes/No)	Coupon
Ibuprofen	NSAID	No	Get coupon
Naproxen	NSAID	No	Get coupon
Aspirin	NSAID	No	Get coupon
Diclofenac (gel)	NSAID	Yes (gel only)	Get coupon
Acetaminophen	Pain reliever, fever reducer	Yes	Get coupon
Robaxin (methocarbamol)	Muscle relaxant	Yes	Get coupon
Lyrica (pregabalin)	Anticonvulsant	Yes	Get coupon

 

Natural pain relief on Eliquis 

There are several non-drug and natural pain relief options that can help people on Eliquis manage discomfort without increasing bleeding risk:

• Physical therapy directed by a professional may include gentle stretches, therapeutic exercises, and the use of machines such as transcutaneous electrical nerve stimulation (TENS). 
• Massage therapy can relieve muscle tension and stress as a part of an integrative pain management plan.
• Acupuncture performed by a qualified professional can be effective for chronic pain.

In all of the above-mentioned therapies, remember to inform your therapist about your medication history before beginning treatment. Practitioners may modify their treatment if you take blood thinners such as Eliquis. For example, massage therapists may avoid applying strong pressure during treatment. 

While some supplements show some promise for pain relief, many natural products can interfere with blood clotting. Fish oil, turmeric, ginger, and garlic, among other herbs, may potentially increase bleeding risk similar to ibuprofen. Though many of these interactions are theoretical, it’s best to consult with your healthcare provider before taking any supplements for pain relief. 

Healthcare providers like Dr. Tambini may recommend lifestyle changes such as therapeutic exercise to help with pain management. “I want to emphasize that lifestyle changes can often complement or even replace medications for managing pain. For example, I recommend low-impact exercises like swimming and yoga, which can help strengthen muscles and improve mobility without putting too much strain on the joints. Additionally, I discuss the advantages of an anti-inflammatory diet that includes foods rich in omega-3 fatty acids, such as fatty fish, and antioxidants found in berries and leafy greens,” she says. 

Other at-home options for pain management include:

• Gentle exercise and stretching
• Mind-body practices such as yoga or tai chi
• Regular sleep and stress management

Though taking ibuprofen and Eliquis together increases the risk of bleeding, there are OTC, non-drug, and natural alternatives for people seeking pain relief. Ask your healthcare provider about which natural or complementary therapies are most appropriate for you. Always inform your healthcare providers about all medications, supplements, and OTC products you’re taking to ensure safe and effective pain management.