Can You Take Tylenol with Eliquis®?

Apixaban (Eliquis) is a factor Xa antagonist or an anticoagulant indicated for reducing the risk of stroke and embolism in patients with nonvalvular atrial fibrillation. There is currently no generic alternative available for Eliquis. There are many prescription and OTC drugs that may interact with apixaban and nonsteroidal anti-inflammatory drugs (NSAID), which is composed of popular pain relievers, are one of them. 
NSAIDs, such as Advil, Motrin, and Aleve, are contraindicated with blood thinners (anticoagulants and antiplatelets) because they may increase the risk of bleeding. NSAIDs are also associated with greater risk for cardiovascular thrombotic events, like heart attack and stroke, thus it may predispose the patient to possibly fatal conditions that Eliquis is trying to prevent. If you have a headache, muscle or joint pains, take acetaminophen instead.

Concomitant use of Tylenol and Eliquis

It is safe to take generic Tylenol while taking Eliquis. Tylenol contains acetaminophen (paracetamol), an active ingredient in hundreds of OTC and prescription medications used to relieve pain and fever. The brand name is owned by a subsidiary of Johnson & Johnson, McNeil Consumer Healthcare. Compared with aspirin, acetaminophen does not prevent blood from clotting, so it can be used by patients who are taking blood thinners. In contrast to NSAIDs, there are fewer gastrointestinal effects associated with paracetamol, and it is generally safe for pediatric patients. Apixaban is often prescribed to prevent clots in the lungs or legs. When a patient requires painkillers, they often self-medicate with common over the counter drugs such as aspirin or ibuprofen. This could be dangerous, as NSAIDs may cause serious internal bleeding when taken with blood thinners such as warfarin, Eliquis, Pradaxa, and Xarelto. Patients must be informed about the dangers of using OTC pain relievers while on Eliquis. If Tylenol or paracetamol does not work for you, ask your doctor for alternative medications that can be taken together with Eliquis.
From a worldwide EINSTEIN study, Xarelto and warfarin were compared among 8,000 patients to determine which drug was more effective for preventing clots in the legs and lungs. The group also looked at whether concomitant use of NSAIDs with these drugs might increase the risk for bleeding. According to the study, the risk for a major bleeding episode for patients taking a blood thinner and aspirin was nearly double than those patients not on aspirin. The risk was triple when taking another form of NSAID while on a blood thinner.

How does Eliquis anticoagulant works?

Apixaban is an oral anticoagulant belonging to a class of drugs called Factor Xa inhibitors. This medication prevents certain enzymes in the blood, such as factor Xa, from forming a blood clot. Eliquis is a direct Factor Xa inhibitor; it selectively binds to the active site of activated factor X (Xa) to block the interaction with its substrate, ultimately inhibiting the final stage of thrombin (clot) generation. This type of anticoagulants inhibits both free factor Xa in solution and within a clot, but they do not have direct effect on platelet accumulation. Common Xa inhibitors like Rivaroxaban, Apixaban, and Edoxaban are rapidly absorbed in the body, reaching a maximum concentration within three hours, more or less. Compared with Rivaroxaban, Apixaban and Edoxaban can be administered with or without food, as their exposure and peak concentrations are not affected by a fed state. Factor Xa inhibitors demonstrate linear, predictable therapeutic effects, thereby avoiding the need for routine monitoring, which is a requirement for vitamin K antagonist (warfarin) therapy.

Approved indications for direct Factor Xa inhibitors

* can be used without initial treatment with parenteral anticoagulant
** can be used in patients with elevated cardiac biomarkers and no previous stroke or TIA episodes, and coadminstered with aspirin or aspirin + clopidogrel or ticlopidine.