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Elsevier
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AI-Generated response:

What are the typical signs and symptoms of thrombocytopenia in patients taking Eliquis?

Answer generated on June 5, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Thrombocytopenia in patients taking Eliquis typically presents with signs of increased bleeding, such as easy bruising, prolonged bleeding from cuts, and unusually heavy or prolonged menstrual bleeding.[1-2]

  • Patients may experience petechiae, small red or purple spots on the body, which indicate minor hemorrhages under the skin.

  • Nosebleeds (epistaxis) and bleeding gums can also be common symptoms.

  • More severe symptoms might include blood in urine (hematuria) or stools, indicating possible internal bleeding.

  • Thrombocytopenia is reported as a less common adverse reaction in patients undergoing hip or knee replacement surgery treated with Eliquis.[2]

  • It is crucial to monitor platelet counts in patients taking Eliquis, especially if they exhibit signs of bleeding or have a medical history that predisposes them to bleeding risks.

Additional info

Thrombocytopenia, while less common, is a significant adverse effect of Eliquis that requires careful monitoring. The physician should be vigilant about the symptoms of thrombocytopenia, especially in patients with other risk factors for bleeding. Regular blood tests to monitor platelet levels can be crucial in patients on Eliquis, particularly if they show signs of increased bleeding or have other conditions that affect blood clotting. In clinical settings, especially post-surgery, the risk of bleeding and related complications like thrombocytopenia should be managed proactively to prevent severe outcomes. Educating patients about the signs of bleeding and ensuring they understand when to seek medical help is vital for safety while using anticoagulants like Eliquis.

References

Reference 1

1.

Elsevier ClinicalKey Drug Monograph

Content last updated: May 4, 2024.

Adverse Reactions GI bleeding (including hematemesis and melena) and hematochezia were reported in less than 1% of eliquis-treated patients in VTE clinical trials. Other adverse events reported in patients treated with eliquis in VTE clinical trials include anemia (including postoperative and hemorrhagic anemia and respective laboratory parameters) (2.6%), contusion (1.4% to 2.2%), hematoma (1.3% to 2%), hemorrhage (including hematoma, vaginal bleeding and urethral hemorrhage) (1.1%), menorrhagia (1.4%), postprocedural hemorrhage (including postprocedural hematoma, wound hemorrhage, vessel puncture site hematoma, and catheter site hemorrhage) (0.9%), thrombocytopenia (less than 1%), epistaxis (3.6% or less), hematuria (2.1% or less), wound secretion (less than 1%), incision-site hemorrhage (less than 1%), operative hemorrhage (less than 1%), gingival bleeding (1.4% or less), hemoptysis (1.2% or less), muscle hemorrhage (less than 1%), menorrhagia (1.4%), ocular hemorrhage (less than 0.1%), and rectal hemorrhage (less than 1%). Educate patients about the signs and symptoms of bleeding, and advise them to report bleeding immediately or to go to an emergency room. Discontinue eliquis in patients with active pathological bleeding.

Adverse Reactions 1. anemia 2. bleeding 3. epistaxis 4. hematoma 5. hematuria 6. hemoptysis 7. menorrhagia 8. vaginal bleeding 9. anaphylactoid reactions 10. elevated hepatic enzymes 11. GI bleeding 12. hematemesis 13. hyperbilirubinemia 14. hypotension 15. intracranial bleeding 16. melena 17. ocular hemorrhage 18. rash 19. stroke 20. syncope 21. thrombocytopenia 22. spinal hematoma

Reference 2

2.

Food and Drug Administration (DailyMed).

Publish date: May 2, 2024.

Adverse Reactions 4. Table 4: Adverse Reactions Occurring in ≥1% of Patients in Either Group Undergoing Hip or Knee Replacement Surgery ELIQUIS (apixaban), n (%) 2.5 mg po bid N=5924 Enoxaparin, n (%) 40 mg sc qd or 30 mg sc q12h N=5904 Nausea 153 (2.6) 159 (2.7) Anemia (including postoperative and hemorrhagic anemia, and respective laboratory parameters) 153 (2.6) 178 (3.0) Contusion 83 (1.4) 115 (1.9) Hemorrhage (including hematoma, and vaginal and urethral hemorrhage) 67 (1.1) 81 (1.4) Postprocedural hemorrhage (including postprocedural hematoma, wound hemorrhage, vessel puncture-site hematoma, and catheter-site hemorrhage) 54 (0.9) 60 (1.0) Transaminases increased (including alanine aminotransferase increased and alanine aminotransferase abnormal) 50 (0.8) 71 (1.2) Aspartate aminotransferase increased 47 (0.8) 69 (1.2) Gamma-glutamyltransferase increased 38 (0.6) 65 (1.1) Less common adverse reactions in ELIQUIS (apixaban)-treated patients undergoing hip or knee replacement surgery occurring at a frequency of ≥0.1% to <1%: Blood and lymphatic system disorders: thrombocytopenia (including platelet count decreases) Vascular disorders: hypotension (including procedural hypotension) Respiratory, thoracic, and mediastinal disorders: epistaxis Gastrointestinal disorders: gastrointestinal hemorrhage (including hematemesis and melena), hematochezia Hepatobiliary disorders: liver function test abnormal, blood alkaline phosphatase increased, blood bilirubin increased Renal and urinary disorders: hematuria (including respective laboratory parameters) Injury, poisoning, and procedural complications: wound secretion, incision-site hemorrhage (including incision-site hematoma), operative hemorrhage Less common adverse reactions in ELIQUIS (apixaban)-treated patients undergoing hip or knee replacement surgery occurring at a frequency of <0.1%: Gingival bleeding, hemoptysis, hypersensitivity, muscle hemorrhage, ocular hemorrhage (including conjunctival hemorrhage), rectal hemorrhage Treatment of DVT and PE and Reduction in the Risk of Recurrence of DVT or PE The safety of ELIQUIS (apixaban) has been evaluated in the AMPLIFY and AMPLIFY-EXT studies, including 2676 patients exposed to ELIQUIS (apixaban) 10 mg twice daily, 3359 patients exposed to ELIQUIS (apixaban) 5 mg twice daily, and 840 patients exposed to ELIQUIS (apixaban) 2.5 mg twice daily.

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