Eliquis (apixaban) is an anticoagulant medication used to prevent blood clots and stroke in people with atrial fibrillation or who have undergone hip or knee replacement surgery. While taking Eliquis, it’s important to be mindful of your diet, as some foods can interact with the medication and increase your risk of bleeding.
Overview of Eliquis
Eliquis belongs to a class of medications called direct oral anticoagulants (DOACs). It works by blocking Factor Xa, an important component in the blood clotting process. By inhibiting Factor Xa, Eliquis prevents the formation of blood clots that could potentially lead to heart attack, stroke or other medical emergencies.
Some key facts about Eliquis:
- Used to treat and prevent blood clots in patients with atrial fibrillation or following hip/knee replacement surgery
- Available as a tablet taken orally twice per day
- Requires no routine blood monitoring
- Carries a risk of increased bleeding as a side effect
- Interacts with some foods that also increase bleeding risk
Because Eliquis works by thinning the blood, it’s essential to be aware of any foods or supplements in your diet that may enhance this effect and increase your chance of uncontrolled bleeding.
Foods That May Interact with Eliquis
Here are some foods and supplements that may interact with Eliquis and increase bleeding risk:
Alcohol
Drinking alcohol while taking Eliquis can increase blood thinning effects. Moderate alcohol consumption (1 drink per day for women and 2 drinks for men) is considered reasonably safe. However, binge drinking and heavy alcohol use can significantly increase bleeding risk.
Grapefruit
Grapefruit contains compounds that interfere with enzymes involved in drug metabolism. This can cause higher than intended levels of Eliquis in the bloodstream, enhancing its anticoagulant effects. Avoid grapefruit juice when taking Eliquis.
Leafy Greens
Leafy greens like kale, spinach and collard greens are high in vitamin K, which plays a role in blood clotting. Eating large amounts of greens can counteract the effects of Eliquis. Maintain a consistent intake of leafy greens while on Eliquis therapy.
Garlic, Ginger and Turmeric
Herbs and spices like garlic, ginger, turmeric and cayenne pepper can also thin the blood in high amounts. Use them in moderation in your cooking.
Omega-3 Fatty Acids
Fish oil supplements contain omega-3 fatty acids like EPA and DHA, which have natural blood-thinning properties. Be cautious with omega-3 supplements while taking Eliquis.
Aspirin and NSAIDs
Aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve) also affect blood clotting and increase bleeding risk when combined with Eliquis. Avoid routine use of these over-the-counter pain relievers without your doctor’s approval.
Vitamin E
High doses of vitamin E supplements can enhance the anticoagulant effects of Eliquis. Don’t take vitamin E supplements above the recommended daily allowance (15 mg per day).
Coenzyme Q10
CoQ10 supplements, often taken for heart health, may also react with Eliquis and increase bleeding tendency. Talk to your doctor before taking CoQ10 while on Eliquis.
Foods That Are Safe to Eat with Eliquis
The following foods are generally considered safe to eat in moderation while taking Eliquis:
- Fruits and vegetables: Apples, berries, citrus fruits, carrots, broccoli, tomatoes, potatoes, etc.
- Whole grains: Oats, brown rice, whole wheat bread, barley, quinoa
- Proteins: Eggs, poultry, fish, beans, nuts, seeds
- Dairy: Milk, yogurt, hard cheeses
- Herbs: Small amounts of thyme, rosemary, parsley, oregano, basil
- Beverages: Water, coffee, tea
Maintain a balanced diet with a variety of fruits, vegetables, whole grains and lean proteins. Keep your intake of greens like kale and spinach consistent day to day. Avoid sudden increases in foods with vitamin K like leafy greens or supplements with omega-3s.
Tips for Reducing Bleeding Risk on Eliquis
Here are some additional tips for minimizing your bleeding risk while taking Eliquis:
- Take Eliquis exactly as prescribed – never double up doses or stop taking it without medical advice.
- Use an electric razor and soft toothbrush to avoid cuts while shaving or brushing.
- Blow your nose gently, don’t pick at nosebleeds.
- Be cautious with sharp objects when cooking and use an electric shaver.
- Wear gloves while gardening and avoid contact sports.
- Tell your doctor about any planned medical or dental procedures.
- Carry medical ID indicating you take a blood thinner.
- Watch for signs of bleeding like passing blood, unexplained bruising, dark stools or prolonged nosebleeds.
Following these diet and lifestyle precautions can help keep you safe while you’re undergoing therapy with Eliquis or other anticoagulant medications.
Foods to Eat More Of
Focusing on getting more of certain foods and nutrients in your diet may also help counteract the blood thinning effects of Eliquis:
Foods High in Vitamin K
Vitamin K plays an essential role in blood clot formation. Getting adequate vitamin K from foods can help stabilize anticoagulation control.
Good food sources of vitamin K:
- Kale, spinach, collard greens, broccoli
- Brussels sprouts, cabbage, lettuce
- Asparagus, green beans
- Avocados
- Blueberries, grapes, prunes
Foods with Vitamin B9 (Folate)
Folate helps regulate red blood cell production and maintain healthy clotting function.
Foods rich in folate include:
- Legumes: Kidney beans, black beans, lentils, edamame
- Nuts and seeds: Peanuts, sunflower seeds, almonds
- Green leafy vegetables
- Asparagus, broccoli
- Oranges, strawberries
Foods with Vitamin B12
Vitamin B12 is also important for proper red blood cell formation and avoiding anemia.
Get vitamin B12 from:
- Animal proteins: Beef, pork, chicken, fish, eggs, dairy
- Fortified cereals and plant-based milk
- Nutritional yeast
Foods with Iron
Iron helps maintain healthy hemoglobin levels in your red blood cells. Low hemoglobin can increase bleeding risk.
Iron-rich foods include:
- Meats: Beef, chicken, pork
- Seafood: Oysters, sardines, shrimp
- Beans: Lentils, chickpeas, kidney beans
- Nuts and seeds: Cashews, pumpkin seeds
- Leafy greens: Spinach, swiss chard
- Dried fruits: Raisins, apricots
Foods with Vitamin C
Vitamin C aids iron absorption. Combine iron-rich foods with vitamin C sources.
High vitamin C foods:
- Citrus fruits: Oranges, grapefruit, lemons
- Broccoli, Brussels sprouts, tomatoes
- Red and green peppers
- Strawberries, papaya, kiwi
- Leafy greens
Sample Meal Plan
Here is a sample one day meal plan with Eliquis-friendly food choices:
| Meal | Food Choices |
|---|---|
| Breakfast | Oatmeal made with milk, berries, almonds, chia seeds |
| Snack | Apple with peanut butter |
| Lunch | Tuna salad sandwich on whole grain bread, melon slices |
| Snack | Edamame hummus with carrot sticks |
| Dinner | Grilled salmon, side salad with spinach, chickpeas and avocado, quinoa |
| Dessert | Greek yogurt with blueberries and walnuts |
This sample menu incorporates iron, folate, vitamin K and vitamin C through plant and animal sources. It also limits foods that may interact with Eliquis, like leafy greens at just one meal.
The Importance of Consistency
When taking Eliquis or related medications, it’s important to keep your vitamin K intake consistent day to day. Don’t make sudden, drastic increases or decreases in foods high in vitamin K like leafy greens.
Try to eat a similar amount of vitamin K-containing foods regularly to maintain stable anticoagulation control.
Vitamin K helps produce clotting factors in your liver that must remain in balance with Eliquis levels in your bloodstream.
Large fluctuations in vitamin K intake can tip this balance, leading to increased risk of bleeding or unwanted clotting.
Talk to Your Healthcare Provider
Before making any major changes to your diet, speak to your doctor about whether certain foods, vitamins or supplements could interact with Eliquis therapy.
They can provide personalized guidance on:
- Your target vitamin K intake
- Recommended daily limits for greens like kale or spinach
- Whether you need a vitamin K supplement
- Safe use of vitamins, herbs or over-the-counter medications
Follow up regularly with your healthcare provider and let them know about any new medications, supplements or major diet changes.
With their input, you can enjoy a balanced diet with Eliquis and reduce the likelihood of problematic food and drug interactions.
The Takeaway
Certain foods and supplements can potentially interact with Eliquis and increase bleeding risk. These include alcohol, grapefruit, high doses of leafy greens, omega-3s, NSAIDs and some herbal supplements.
Safer food choices include fruits, vegetables, whole grains, lean proteins, dairy and moderate amounts of herbs. Get adequate iron, folate, vitamins K and B12.
Keep your intake of vitamin K foods stable. Follow dosing instructions carefully and watch for signs of bleeding.
With guidance from your doctor and some mindfulness around your diet, you can safely take Eliquis to reduce your risk of dangerous blood clots.
