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Combining prescription medications with alcohol can lead to unexpected and sometimes dangerous interactions, particularly with blood thinners like Eliquis (apixaban). While some might consider an occasional drink harmless, even moderate alcohol consumption can amplify the medication’s effects, increasing the risk of complications.

A case-control study involving 570 patients on warfarin, another blood thinner, found that those consuming five or more drinks per occasion faced more than double the risk of major bleeding events compared to non-drinkers.

This article offers essential insights into the interactions between Eliquis and alcohol, along with key safety precautions. Knowing this information can help you make informed choices and manage your health effectively while taking Eliquis.

Key Findings

  • Combining Eliquis with alcohol heightens bleeding risks since both reduce blood clotting.
  • There is no safe level of alcohol consumption when on Eliquis, as even small amounts pose a risk to health.
  • If permitted by a doctor, light beer, certain wines, and low-alcohol cocktails are “safer” choices for those on Eliquis. Hard liquors should be avoided due to their greater impact on bleeding and side effects.
  • Drinking alcohol while on Eliquis can harm liver function, which could lead to unpredictable Eliquis levels, affecting its effectiveness and safety.
  • Alcohol also raises the risk of falls and high blood pressure, both potentially dangerous for Eliquis users due to their heightened risk of internal bleeding and hemorrhagic stroke.

Can you drink alcohol with Eliquis?

There is no absolute restriction against alcohol use for people on Eliquis. Most healthcare providers advise patients to limit alcohol intake to the lowest possible amount or avoid it altogether. The primary risk of combining Eliquis and alcohol consumption is the heightened possibility of bleeding, since both substances independently affect blood clotting.

Does alcohol thin your blood?

Yes, alcohol has a mild blood thinning effect. Studies show that shortly after drinking, platelets become less likely to “aggregate” or clump together. This effect reduces the blood’s ability to clot, similar to how Eliquis works, though much weaker and achieved through a different mechanism.

While this reduction in clotting can lower the risk of heart attacks and ischemic strokes, heavy or binge drinking raises the risk of cerebral hemorrhage (bleeding within the brain). In fact, internal bleeding from alcohol occurs more often than most people realize. A 2015 study, for example, found that 19.7% of patients hospitalized for gastrointestinal bleeding were heavy alcohol users.

How much alcohol can you safely drink while taking Eliquis?

When taking Eliquis, there is no completely safe level of alcohol consumption, as even small amounts can increase health risks. If your doctor approves alcohol drinking, limit intake to moderate levels.

The 2020-2025 Dietary Guidelines for Americans suggest that women limit alcohol to 1 drink or less per day and men to 2 drinks or less per day. One standard alcoholic drink contains 14 grams (0.6 fl oz) of pure alcohol, which is equivalent to:

    • 12 fluid ounces of regular beer (5% alcohol),
    • 5 fluid ounces of wine (12% alcohol),
    • 1.5 fluid ounces of 80-proof distilled spirits (40% alcohol).

A longitudinal study involving men revealed that those who consumed more than 2 drinks per day had a 43% higher likelihood of experiencing major gastrointestinal bleeds compared to non-drinkers.

Binge drinking is defined as a pattern that raises blood alcohol concentration to 0.08% or higher, typically achieved when a woman has 4 or more drinks, or a man has 5 or more drinks, within about 2 hours. Heavy drinking, which includes binge drinking, is defined as 4 or more drinks on any day or 8 or more per week for women, and 5 or more drinks on any day or 15 or more per week for men.

We cannot talk about a so-called safe level of alcohol use. It doesn’t matter how much you drink–the risk to the drinker’s health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is – or, in other words, the less you drink, the safer it is.

–Dr. Carina Ferreira-Borges, acting Unit Lead for Noncommunicable Disease Management and Regional Advisor for Alcohol and Illicit Drugs in the WHO Regional Office for Europe

Which alcoholic beverages are safe to consume with Eliquis?

Which alcoholic beverages are safe to consume with Eliquis?

Choose beverages that don’t encourage quick or heavy consumption. Consider the following:

    • Light Beer: Bud Light, Miller Lite, Coors Light, and Michelob Ultra, are among the best-selling beers in the US. Brands like Corona Light, Amstel Light, and Heineken Light are also popular.
    • Red Wine: Popular types of red wine include Cabernet Sauvignon, Pinot Noir, Merlot, Zinfandel, Malbec, and Syrah/Shiraz.
    • Low-Alcohol Cocktails: Options like a spritzer (wine mixed with soda water) dilute the alcohol, helping to keep consumption low. Other popular cocktails include aperol spritz, sherry cobbler, americano, and cider mimosa.

Although wine has a moderate ABV (alcohol by volume) compared to other alcoholic beverages, a recent study found that alcohol’s blood-thinning effects were more pronounced with wine and liquor than with beer. White wine, in particular, showed reduced platelet activity, while red wine did not.

Avoid hard liquors, as they generally contain higher alcohol concentrations, which can increase potential risks. Common examples include:

    • Vodka, Whiskey, Gin, Rum, Tequila
    • Brandy, Cognac, Scotch, Bourbon, Absinthe

Note that alcohol can dehydrate you, heightening Eliquis side effects, so drink water alongside any alcoholic beverage.

Pro Tip: Consider Mocktails!

Mocktails are non-alcoholic drinks made to mimic traditional cocktails in flavor, complexity, and presentation. They often incorporate fresh fruits, herbs, syrups, and even zero-proof “spirits” that mimic the taste profiles of alcohol, creating a sophisticated drinking experience.

Eliquis and Alcohol Side Effects to Watch For

Alcohol can severely damage the gastrointestinal (GI) mucosa, increasing the risk of GI bleeding. Since Eliquis’s most common side effect is also bleeding, combining the two can raise this risk further and lead to serious complications. Here are the symptoms to watch for:

    • Persistent headaches or dizziness
    • Unusual bruising
    • Prolonged bleeding from minor cuts or injuries
    • Coughing up or vomiting blood
    • Blood in the stool (black, tarry stools) or in the urine
    • Development of ulcers
    • Stroke-like symptoms (sudden numbness, weakness, or confusion)
    • Chest or abdominal pain
    • Heavier-than-normal menstrual bleeding
    • Bleeding gums or nosebleeds that do not stop

If you experience any of these symptoms, seek immediate medical help.

More importantly, different organs respond differently to internal bleeding. Some organs may tolerate small amounts of bleeding for a time without showing symptoms, while others may exhibit signs of reduced function even with minimal bleeding.

Other Risks of Combining Alcohol and Eliquis

Man Drinking Alcohol

Beyond the increased bleeding risk, drinking alcohol while on Eliquis can lead to other serious complications. Potential issues include:

1. Impaired Liver Function

The liver is essential in metabolizing both alcohol and Eliquis. Consuming alcohol can impair liver function, which may alter how Eliquis is processed. Over time, this could affect how Eliquis is metabolized, potentially leading to unpredictable levels of the medication in the body and increased bleeding or clotting risks.

2. Increased Risk of Falls and Injuries

Alcohol impairs coordination, balance, and judgment, making falls and accidents more likely. A meta-analysis showed that each 10-gram increase in alcohol intake raises the risk of a fall-related injury by 1.3 times. Another study found that two drinks increase this risk by 3.7 times, while three or more drinks raise it by 12.9 times.

For someone taking Eliquis, falls are especially dangerous because the blood-thinning effect makes it difficult to stop bleeding, even from minor injuries. Internal bleeding, such as in the brain after a head injury, can be life-threatening and harder to detect and treat quickly.

3. Elevated Blood Pressure

Researchers found a direct and linear relationship between alcohol consumption and increased blood pressure, showing no safe threshold. People drinking 12 grams of alcohol daily showed a rise in systolic blood pressure (SBP) by 1.25 mm Hg, while those consuming 48 grams daily had an SBP increase of 4.90 mm Hg. Diastolic blood pressure (DBP) also increased, though the effect varied by sex and region.

This rise in blood pressure is concerning because it can damage blood vessels in the brain, potentially causing bleeding (hemorrhagic stroke). For individuals on Eliquis, this bleeding risk is already elevated, which can make a hemorrhagic stroke more severe if it occurs.

Takeaway

While drinking alcohol on Eliquis isn’t strictly prohibited, it carries significant risks. Both alcohol and Eliquis thin the blood, increasing the chances of dangerous bleeding, especially internally. Alcohol can also raise blood pressure and strain the liver causing other complications when combined with Eliquis.

For those who choose to drink, limit alcohol to light options like beer or wine spritzers, and avoid hard liquor. Watch closely for symptoms of bleeding, such as unusual bruising, prolonged bleeding, or blood in stool or urine, and seek immediate medical help if they occur. Most doctors advise that the safest choice is to avoid alcohol or drink very minimally to reduce these serious health risks.

What to Read Next

If you’re interested in learning more about Eliquis, check out our next articles:

These articles offer practical advice to help you confidently manage your medication and health.

Frequently Asked Questions

Yes, excessive alcohol consumption can raise the risk of blood clots. Chronic heavy drinking may alter the blood’s clotting mechanism, increase blood pressure, and cause vascular issues, which can contribute to clot formation. Long-term alcohol abuse is associated with heart and liver conditions that also increase clot risk.

Yes, some foods have natural blood-thinning properties. Foods like garlic, ginger, turmeric, and those rich in vitamin E (e.g., almonds, sunflower seeds) may reduce blood clotting. Certain fruits, like berries and grapes, contain antioxidants that also have mild anticoagulant effects.

Blood thinners don’t directly alter your sensation of temperature. Although some people report feeling colder, changes in temperature perception are highly individual and not definitively linked to the viscosity of blood.

No, all blood thinners carry bleeding risks, and alcohol can increase these risks regardless of the blood thinner type.

No blood thinners, including Eliquis alternatives, are considered fully safe to mix with alcohol.

Drinking alcohol while on blood thinners is generally discouraged as it raises the risk of bleeding.

Eliquis works by blocking Factor Xa, a protein vital to the blood clotting process. By inhibiting this protein, Eliquis reduces clot formation, making blood less likely to clot and effectively thinning it.

Caution is recommended when combining turmeric with Eliquis, as turmeric has natural blood-thinning properties. Consuming both together may amplify bleeding risks, so it’s best to consult a healthcare provider for personalized advice.

Related Articles

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