Key takeaways
Tylenol (acetaminophen) is considered safe to take with Eliquis (apixaban) as there are no known interactions that increase the risk of bleeding.
Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and certain antidepressants should generally not be taken with Eliquis due to the increased risk of bleeding they present.
Warning signs of dangerous bleeding while on Eliquis include red, pink, or brown urine; red or black stool; coughing up blood; and unusual bleeding or bruising, among others.
Alternative pain relief methods safe for Eliquis users include OTC topical anesthetics like lidocaine, certain prescription medications, and non-medication treatments such as acupuncture and physical therapy.
Eliquis (apixaban) is a brand-name medication called a Factor Xa Inhibitor that works as an anti-clotting drug to prevent and treat blood clots. Blood clots can travel to different parts of the body, including the legs and lungs, and increase the risk of stroke or embolism (blocking of an artery). These clots can form from abnormal heart rhythms (also called atrial fibrillation) or surgery. Different types of clots include stroke (a blood clot in the brain), deep vein thrombosis (DVT), and pulmonary embolism (PE).
Tylenol is the brand name of acetaminophen. It is available over the counter as a pain reliever and fever reducer. Tylenol is available as an over-the-counter (OTC) and in a variety of dosage types (such as tablets, chewable tablets, softgels, gelcaps, and liquid) and formulations (such as regular strength, extra strength, and extended release). Tylenol can be used for various health conditions, including headache, backache, arthritis, toothache, fever, muscle aches, and menstrual cramps.
People taking Eliquis may need pain relievers for general aches and pains or pain associated with surgery recovery. As an anti-clotting medication, Eliquis can thin the blood and increase the risk of bleeding. It’s important for people to use pain relievers that do not cause dangerous drug interactions with Eliquis or further increase the risk of adverse effects like bleeding.
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RELATED: Eliquis alternatives: What can I take instead of Eliquis?
Can you take Eliquis and Tylenol together?
Tylenol is a safe OTC pain reliever to take with Eliquis. There are no known interactions between Eliquis and Tylenol. Tylenol is not a blood thinner and does not further increase the risk of bleeding. Since Tylenol is also available as combination products, it’s important to check if these products contain medicines that may interact with Eliquis. For example, Tylenol PM contains the sleep aid diphenhydramine in addition to acetaminophen and is safe to take with Eliquis.
Eliquis and pain relievers
Like Tylenol PM, many combination products contain Tylenol’s active ingredient, acetaminophen (also called paracetamol), and are safe to take with Eliquis. However, the combination products Advil Dual Action (acetaminophen and ibuprofen) and Excedrin (acetaminophen, aspirin, and caffeine)should be avoided with Eliquis due to the additional ingredients ibuprofen and aspirin, which can increase bleeding.
In general, Eliquis and other blood thinners like Xarelto (rivaroxaban), Pradaxa (dabigatran), Coumadin (warfarin), and heparin should not be taken with non-steroidal anti-inflammatory drugs (NSAIDs) and certain antidepressants used for pain, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs). These combinations should be avoided because NSAIDs and certain antidepressants can also increase the risk of bleeding by influencing how platelets work.
While taking Eliquis, people may bruise more easily. However, some indicators of possible dangerous bleeding should be addressed immediately, as they can be serious side effects. People should call their healthcare provider or seek immediate medical attention with the following signs and symptoms:
- Severe bleeding that is uncontrollable
- Red, pink, or brown urine
- Red or black tar-like stools
- Coughing up blood
- Throwing up vomit that looks like coffee grounds
- Bleeding from the gums that lasts a long time
- Frequent nosebleeds
- Menstrual bleeding or vaginal bleeding that is heavier than normal
- Unexpected pain, swelling, or joint pain
- Headaches, feeling dizzy or weak
RELATED: Eliquis side effects and how to avoid them
For people experiencing pain in a specific area of the body, OTC topical anesthetics like lidocaine cream and Icy Hot patches (menthol) are safe to use with Eliquis. These are also ideal for people who have certain medical conditions that make it difficult to swallow medicine by mouth or people who need to avoid the unwanted side effects of oral painkillers.
Other pain relief options include prescription drugs such as muscle relaxers, opioids, and steroids.
| What type of pain medication is safe with Eliquis? | |||
|---|---|---|---|
| Drug name | Drug class | Safe to take with Eliquis? | More information |
| Tylenol (acetaminophen) | Analgesic | Yes | Tylenol coupons |
| Advil, Motrin (ibuprofen) | NSAID | No | Advil details |
| Aleve (naproxen) | NSAID | No | Aleve details |
| Aspirin | NSAID | Depends on the dose. Low dose 81 mg (baby aspirin) can be used if advised by a doctor as combination therapy for heart attack or stroke prevention. | Aspirin coupons |
| Celebrex (celecoxib) | NSAID | No | Celebrex details |
| ConZip
(tramadol) |
Opioid | Yes | ConZip coupons |
| Cymbalta (duloxetine) | Antidepressant | No | Cymbalta details |
| Fexmid, Amrix (cyclobenzaprine) | Muscle relaxer | Yes | Fexmid coupons |
| Indomethacin | NSAID | No | Indomethacin details |
| Lidoderm (lidocaine patch) | Local anesthetic | Yes | Lidoderm coupons |
| Lofena
(diclofenac) |
NSAID | No | Diclofenac details |
| Lyrica (pregabalin) | Anticonvulsant | Yes | Lyrica coupons |
| Medrol (methylprednisolone) | Steroid | Yes | Medrol coupons |
| Meloxicam | NSAID | No | Meloxicam details |
| Neurontin (gabapentin) | Anticonvulsant | Yes | Neurontin coupons |
| Norco (hydrocodone-acetaminophen) | Opioid | Yes | Hydrocodone-acetaminophen coupons |
| Percocet (oxycodone-acetaminophen) | Opioid | Yes | Percocet coupons |
| Rayos
(prednisone) |
Steroid | Yes | Rayos coupons |
| Tanlor (methocarbamol) | Muscle relaxer | Yes | Tanlor coupons |
RELATED: 8 non-narcotic pain meds and other pain management tips
Natural pain relief for people taking Eliquis
Several alternative treatment options are available for people taking Eliquis. Some alternative medicine includes acupuncture, chiropractic adjustments, physical therapy, and massage therapy.
Acupuncture is a common alternative medicine in which a professional inserts thin needles into the skin to stimulate nerves and muscles. Multiple studies have shown its effectiveness in treating back pain (either acute or chronic), knee pain secondary to osteoarthritis, myofascial pain, and headaches. Acupuncture is considered safe in people using newer FDA-approved anticoagulants such as Eliquis, Xarelto, and Savaysa.
Physical therapy can be useful for chronic or acute pain management after injuries or surgeries. Physical therapy can help improve strength, flexibility, endurance, power, and agility, all of which help the body function better and process pain more efficiently. Many people notice an improved quality of life after regular physical therapy sessions. Additionally, physical therapy can help people get back on their feet after other medical issues, such as a stroke. Physical therapists can play an important role in identifying signs and symptoms of a potential blood clot and helping people recover from clots.
It is important to seek out medical advice from trusted healthcare providers, such as pharmacists, before starting any supplements or vitamins, as some may increase the risk of bleeding.
- Eliquis drug information, Bristol Myers Squibb and Pfizer
- Prevalence and knowledge of potential interactions between over-the-counter products and apixaban, Journal of the American Geriatrics Society (2019)
- Drug interactions with apixaban: a systematic review of the literature and an analysis of VigiBase the World Health Organization database of spontaneous safety reports, Pharmacology Research & Perspectives (2020)
- Safety of acupuncture in patients taking newer oral anticoagulants: a retrospective chart review study, Evidence-based Complementary and Alternative Medicine (2018)