My husband started Apixiban 5 mg twice a day after an AFib episode in late November (mostly likely due to his worsening sleep apnea according to the doctors). He tolerates most medications well but after six weeks on Apixiban and Metoprolol his liver enzymes were suddenly elevated. Has anyone else experienced this issue?
Apixiban and liver issues: My husband... - Atrial Fibrillati...
Apixiban and liver issues
Written by
sakobrien
To view profiles and participate in discussions please or .
Read more about...
69 Replies
•
From reading, Apixaban may cause elevataed enzymes of the liver. Links are not permitted without permission so you may want to google the subject. Google NIH, Apixaban, liver injury,
Was the elevation above the normal range ? Best to discuss with your doctor for a possible retest, additional tests, and possibly a change from Apixaban or a reduced dosage.
I have taken Apixaban for 4 years and just had recent elevation of enzymes. Currently going thru a retest and evaluation.
I did check a couple of the links and liver damage can happen on a few occasions. He is seeing his primary care doctor this week to review his medications. His levels were twice the normal and his last blood test was about three weeks prior. He also takes sodium tablets because his sodium levels are consistently low, but that has Ben happening for almost 5 years. It seems to run on his family. Thank you.
Has he been tested for hemachomatosis ? Easy test of dna. ( 23 and me ) tested our daughter. We spent ten months with my husband’s liver enzymes rising like crazy, til doctor had dna tested and discovered hemochromatosis! Common blood disorder among Northern European heritage, especially Irish, Scottish and English, can be fatal without treatment.
Treatment is simple. His blood is drawn ( about a pt) every six months. This has been last ten years, no issue any longer, but it’s hereditary so watching one daughter who tested same. Not often major issue for females before menopause.
May be common knowledge, these days, however thought Id share as no pharmaceutical industry gets rich on simply drawing your blood to save your life!🤷♀️
Good luck.
Is he taking it with food?
manabouttown . Hi man, your reply went to me instead of the OP Sami.
Hi,
I would ask my Dr. or a qualified Pharmacist for a full review of all medication that has been prescribed. I'm in UK not USA so I really can't comment on medical practices and procedures where you are ......... I also don't know what other medication you are taking that possibly you haven't mentioned. A Pharmacist is my preference because they can look at the interaction between different drugs, not just the side effect of say, Apixaban.
Apixaban is one of a family of 4 new anticoagulants, the others being, Edoxaban, Dabigatran and Rivaroxaban. Then there is an old - tried and true - Warfarin ( Coumadin). As I say, maybe its time for you and a Pharmacist to conduct a review of medication.
In the real world, a pharmacist is unlikely to review meds with a person...no one in the medical profession has enough time to do anything that people seem to think they do.
I don't know where your real world is but mine is in the UK, south West, and I can access a Pharmacist at my local Boots providing I make an appointment. My local NHS Surgery also employs a Pharmacist and I can see her through the normal surgery appointment system or have a telephone appointment anytime, again, providing I use the surgery appointment system. Hardly rocket science. I guess you must be in a deprived NHS area.
I actually was taking 500 mg of levaquin once a day for over a year. While in hospital they put me on 750 ml when leaving because of possible pneumonia. I was like "I think that 1200 mg of levaquin is tooooo much so I put the original 500 on hold to take the 750 and now will continue my 500 mg. I happened to mention it to the pharmacist who fills BOTH scripts and he was like "omg that's over 1000 mg!! Good thing you knew and didn't take them both"😳😳😳. I'm like holy mackerel. Isn't that YOUR job to see that ?(I didn't say it to him but I def thought it!!) He never catches things lol but always confirms when I bring it to his attention 😳🦄
I had a friend who has elevated liver enzymes, on Rivaroxaban. Turned out that she had not been taking it correctly and as soon as she did, liver enzymes returned to normal.
Is your husband taking with a full glass of water, twice daily at roughly the correct time?
As a matter of interest, is the sleep apnea treated?
I didn't know Apixaban needs a full glass of water,but will do so now!
Nor me. I take with no water sometimes. This should surely have been explained to us
You'd like to think so eh? Huh! Will do now! Especially on Flecanide too x
I’ve always been advised to take any and all drugs with a full glass of water. I thought it was normal practice and commonly known. Otherwise medication is prone to sit high in the digestive tract which can also cause digestive tract issues.
I always take all medication with water but when people talk about a full glass, how big is the glass?
Mine is probably 250ml. I kind of think of it as counting toward of my 1-2L per day requirement. Two of those a day and I’ve covered half a litre.
250ml
I always call a glass 8 oz (American lol) thus I consider my 16 oz glass two glasses of water.
Yes the package insert just says 'with or without food' for Apixaban
Me neither. I take morning one with first brew of the day and evening one with my supper.
My instructions say "a drink of water" not a glass full. Have always taken mine with a swig and haven't had any issues as yet.
Neither did I. I usually take mine after breakfast and a full mug of tea, and at night with a full mug of boiled milk.
We did not know about full glass of water, but will try that now. Thanks! And yes, the sleep apnea is being treated. He just had a sleep study done and received a new machine. We’re hoping for better results.
What test shows whether you have elevated liver enzymes?
Full blood test
I'm not sure but I think it's called a Complete Metabolic Panel, usually with a CBC
How old is your husband? A half dose is recommended for anyone over 80 and weighing less than 60kg or with kidney issues.
My husband is 69 and had been in good health since he retired 2 years ago. After developing the sleep apnea his CPAP was working fine for a while then the sleep apnea worsened and he had terrible insomnia. Being a heart patient who has experienced AFib, I was worried he would experience it from the sleep issue and he did! That was about six weeks ago. He had only one day occurrence of AFib that resolved on its own. The escalated liver enzymes were a complete surprise.
I hope he is ok now 😳❤️🦄
He’s getting rechecked this month.
I started taking Apixoban in May 2024. I had a blood test in August saying enzyme levels were well within the range. However in my most recent test in January it is revealed that my enzyme levels are outside the accepted range . I had assumed that this was as a result of other meds that I've been taking or a combination of them all. The doc has suggested that regular monitoring will be pursued but indicated that the increase in levels was insufficient to cause immediate concern
Easy for him to say 😁😁😵💫
I've taken apixaban with verapamil for years and never had any problems. I do make sure I have them at the proper time. I haven't heard about the full glass of water either but I only ever take them with just over half a glass of water
Yes I have experienced this issue too but the thought of changing to Warfarin does not fill me with delight . Regards Roger
warfarin can also present a greater chance of bleeding than eliquis (apixaban). The rise in liver enzymes is concerning and is also listed as a possible adverse effect. They say that these doacs don't have to be monitored but it looks like they do...at least for the liver enzymes. Amazing how they docs don't seem to think this is an issue. I don't think the docs are really well versed in all that can go wrong with these meds...such as gastrointestinal bleeding. They know about it of course, but like with any new, expensive drug that the med reps shower them with, we become the guinea pigs.
Yes, I had a bloods workup done during the time I was on Apixaban following my ablation and there was some alarm about my raised liver reading, which was way out of the 'normal' range. After some thought I asked my doc if the reading could have been caused by the Apixaban and after some brief research she confirmed that it could. After discontinuing the Apixaban a subsequent blood test showed a normal reading.
Did you go on another blood thinner? I was originally on Lovenox abdominal shots but they felt they were the culprit with me getting MORE embolisms so was taken off that and put in Eliquis (apixaban)
No, I'm not on any meds.
lovenox is not a drug for atrial fib. While it's an anticoagulant, it's not indicated for atrial fib.
Have you heard of Haemochromatisis? This is a genetic Celtic liver disorder. Many have ut without knowing and apparent supposed to be common but rarely tested for!
I have Haemochromatisis the Compound variant which doesn’t get the same importance as the Other variant. I am also on Apixaban, lowered dosage to 2.5mg twice a day in case of strokes 😉
May I ask since you were put on the lower dose of 2.5 mg. twice a day, do you also meet the parameters for that dosage? I wanted my doc to lower my dose also but she would not as I don't meet the parameters of age and weight and they don't think the lesser dose is as effective. I wish they would consider lowering the dose though that for those of us who may not be able to tolerate these meds as well.
I had an ablation end of Feb 2024. I continued on the 2 x 5mg for few months. Some hospital medics had queried why. The Prof just kept me on them! I tripped spectacularly on holiday, long story but was not due to my age or anything and I had a MASSIVE bruising with haematoma on my hip and buttock, this was down to being on Apixaban!! I was told by another consultant only couple of months ago. So when I saw my consultant cardiologist we agreed I’d take the 2.5mg x 2 for safety. But if I start having AF will probably have to up the dose.
I also have T2 diabetes 😳
you could get her to do a clotting factor test. I am also a ‘bleeder’, my sister is too. I had a blood test to look for a bleeding factor but I think you can get a clotting factor test.
I have also been having issues with the last three blood tests. I have had an ultrasound and everything is fine so looking for reasons. My GP has ordered more bloods he said we will try and look at the liver in different way! We discussed stopping the statin but he wants to do these tests first. Never thought apixaban could be the culprit and I don’t think he did either I suppose it’s a process of illumination but we need our blood thinners.
It's very infuriating that they pump these new "wonder" drugs out at everyone & then later discover they affect major organs like the liver.
Just out of curiosity as I just happened onto this conversation and I also happen to have a PFO too!! Have you ever taken voraconazole or posaconazole with or without venetoclax? My urine turned ORANGE!!! And liver tests shot up!! 😳😳😳
No never!
It is recommended to have at least yearly liver function tests and kidney function tests on DOACs.My alkaline is a bit outside the higher normal range and has been for several years, my GPs response is "as expected" on the report.
Incidentally I try to fast before blood tests as especially if you are O Pos for some reason it can make a difference.Sorry can't remember where I read that.
I have morning apixaban with a mug of tea and second one with meal and maybe half a glass of water
morning, I am in the uk, I have been taking Apixaban for over 3 years now for Afib, liver levels ok at present, I was told to take it 12 hours apart, no mention of a full glass of water, just with water.
Hope they sort things out for your husband.
I’m following this with interest and wondered if anyone else has had altered blood results while taking anticoagulants. I’m a 71 year old woman, don’t smoke or drink, have a very healthy diet and any blood tests have always come back normal. I started taking Apixaban last February for PAF and had an ablation in May, which has held so far. A routine blood check before taking Apixaban was normal, but another in November showed my kidneys weren’t working quite as well as previously. Now I know our bodies change as we get older but this has happened in the exact 9 months I’ve been on the drug, which seems a bit suspicious. Thankfully it’s only a slight change at the moment but I’m concerned. Has this happened to anyone else?
I was changed to Apixaban after suffering a third stroke aged 52.
Ever since taking it, I've suffered with right side abdominal pain. I'm on a waiting list to see a gastro.
I started Apixaban September 2023, was previously on Clopidogrel. The cause of my first stroke aged 34 was a PFO (hole in heart) which was never fixed.
I’m sorry to hear about your situation. I was born with a hole in my heart and bad pulmonary stenosis. Had surgery when I was five to patch the hole and correct my stenosis but finally had a pulmonary valve replacement two years ago. My energy soared after that surgery. I wish I had it sooner!
I'm so glad you have more energy. I wish I had a little, i feel like an 87 old, not a 53 year old.
I was told I was too old for PFO closure in 2023 by a locum cardiologist, I know that the NHS close PFO's up to 60 and sometimes over.
Managed to see another cardiologist at the same hospital, he has referred me to see another cardiologist at Stoke to discuss closure. The wait to see him was 9 months, so hopefully by March.
God knows how long for PFO to be repaired after that.
I was born with a PFO too and diagnosed with it (called it a heart murmur) when I was 6 but nothing done and never ever had a problem. When I was starting in my leukemia journey ALL of the cardiologists wanted me to undergo a procedure where they use this umbrella type thingie that goes through the hole and when you pop it open it closes the hole. Then your skin grows over it. Well I scar inside really really really bad so I was having a virtual with a top NYC surgeon and I said to him "what happens when my scar tissue starts attacking it and covers my skin and gets heavier and heavier and you have to take the "umbrella" out?😳. I read how part of your heart has to come out too!" I saw his shoulder drop as he was writing and he looked at me and said "I will never EVER do this procedure on you!😳" I thought it the funniest thing because he was right! This was not a procedure for someone like me!! Now I have leukemia and suddenly developed a massive embolism on my right lung along the heart valve. Went in for a procedure to "suck" it out! After three hours and trying every which way to do it (and I was awake and laying still on the table listening to them trying to figure out what to do!) they had to leave it as it wouldn't budge 😳😳😳. But I don't think it was because of my PFO. I think it was caused by my leukemia as cancer can actually cause embolisms!!!
I would be concerned for the liver with right sided abdominal pain. Perhaps ask for blood tests to be run?
Thank you for your reply.
I will mention it again at my GP appointment tomorrow, and also at my rheumy appointment next week.
odd that you say that! Is Apixaban also called Eliquis????? Because I am now taking both Eliquis and metoprolol (which I've been on for years ) and I do think my liver numbers are somewhat off 😳😳. I just looked it up and it IS Eliquis!!!! Something else to ask my doctor!! Thank you !!! 🙂🦄
Not what you're looking for?
You may also like...
apixiban and tumeric
I stopped taking tumeric and related supplements when I started taking apixiban on advice of...
Dentist and Apixiban
I'm due to have a small tooth out, any advice on when to stop taking Apixiban please.
Apixiban
Good morning all,
For years I have taken Eliquis apixiban, 5mg twice a day, yesterday I collected...
Apixiban and joint pain
Hoping you might be able to help. After being on Warfarin for 6 years I was encouraged to change to...
Cataract surgery and Apixiban
Apixiban and Letrozole
apixiban and biopsy
Headaches with apixiban
