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- Aspirin vs. Eliquis (apixaban): Similarities and differences
- What is aspirin? What is Eliquis?
- What are the side effects of aspirin and Eliquis?
- What is the dosage of aspirin vs. Eliquis?
- What drugs interact with aspirin vs. Eliquis?
- Are aspirin and Eliquis safe to take while pregnant or breastfeeding?
Aspirin vs. Eliquis (apixaban): Similarities and differences
- Aspirin and Eliquis (apixaban) are anticoagulants used to prevent blood clots (antithrombotics).
- Aspirin is also used to treat fever, pain, and inflammation in the body.
- Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) and Eliquis is an anticoagulant (blood thinner).
- Brand names for aspirin include Bayer Aspirin, Ecotrin, and E.C. Prin.
- Aspirin is available over-the-counter (OTC) and as a generic.
- Side effects of aspirin and Eliquis that are similar include gastrointestinal bleeding and rash.
- Side effects of aspirin that are different from Eliquis include abdominal pain, abdominal burning, cramping, gastritis, stomach ulcers, nausea, ringing in the ears, dizziness, liver toxicity, kidney impairment, and spinning sensation (vertigo).
- Side effects of Eliquis that are different from aspirin including bleeding in the brain and eyes.
What is aspirin? What is Eliquis?
Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) used to treat fever, pain, and inflammation. Aspirin is also used to prevent blood clots (antithrombotic). Other NSAIDs include ibuprofen (Motrin), indomethacin (Indocin), and nabumetone (Relafen). NSAIDs reduce levels of prostaglandins, chemicals released when there is inflammation that causes pain and fever. NSAIDs block the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins, and a reduction of inflammation, pain, and fever. Suppression of prostaglandins also reduces the function of platelets and the blood’s ability to clot. Aspirin inhibits the function of platelets for prolonged periods of time so it is used to reduce the risk of another heart attack or stroke in people who have already had a heart attack or stroke.
Eliquis (apixaban) is an anticoagulant (blood thinner) used for reducing the risk of blood clots in the heart and strokes in patients with atrial fibrillation who have no problems with their heart valves (nonvalvular atrial fibrillation). Eliquis is also used to treat and prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients who have undergone hip or knee replacement surgery.
What are the side effects of aspirin and Eliquis?
Most patients benefit from aspirin and other NSAIDs with few side effects. However, serious side effects can occur and generally tend to be dose-related. Therefore, it is advisable to use the lowest effective dose to minimize side effects.
The most common side effects of aspirin involve the gastrointestinal system and ringing in the ears.
Gastrointestinal side effects are
- abdominal burning,
- gastritis, and
- even serious gastrointestinal bleeding and
- liver toxicity.
Ringing in the ears
- Should ringing in the ears occur, the daily dose should be reduced.
Other side effects include:
Other side effects and adverse reactions
- Aspirin should be avoided by patients with peptic ulcer disease or poor kidney function, since this medication can aggravate both conditions.
- Aspirin may exacerbate asthma.
- Aspirin can raise the blood uric acid level and is avoided in patients with hyperuricemia and gout.
- Children and teenagers should avoid aspirin for symptoms of the flu or chickenpox because of the associated risk of Reye's Syndrome, a serious disease of the liver and nervous system that can lead to coma and death.
- Aspirin can increase the effect of medicines used to treat diabetes mellitus, resulting in abnormally low blood sugars if blood sugar levels are not monitored.
- NSAIDs should be discontinued prior to elective surgery because of a mild tendency to interfere with blood clotting. Aspirin, because of its prolonged effect on platelets, is best discontinued at least ten to fourteen days in advance of the procedure.
The most common side effects of apixaban involve bleeding in the:
- brain, and
Bleeding due to apixaban may be fatal.
Rash and serious allergic reactions also may occur.
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What is the dosage of aspirin vs. Eliquis?
Aspirin should be taken with food. Doses range from 50 mg to 6000 mg daily depending on the use.
- Usual doses for mild to moderate pain are 350 or 650 mg every 4 hours or 500 mg every 6 hours.
- Doses for rheumatoid arthritis include 500 mg every 4-6 hours; 650 mg every 4 hours; 1000 mg every 4-6 hours; 1950 mg twice daily.
- Heart attacks are prevented with 75, 81, 162 or 325 mg daily.
- 160 to 325 mg of non-enteric coated aspirin should be chewed immediately when experiencing symptoms of a heart attack.
- The dose for preventing another stroke is 75 to 100 mg daily.
- The usual dose in nonvalvular atrial fibrillation is 5 mg by mouth twice daily. For individuals 80 years or older, weighing less than or equal to 60 kg, or with reduced kidney function, the usual dose is 2.5 mg twice daily.
- The recommended dose for treating DVT or pulmonary embolism is 10 mg twice daily for the first 7 days and then 5 mg twice daily. After six months of treatment, the dose may be reduced to 2.5 mg daily for prevention of DVT or pulmonary embolism.
- When apixaban is used to prevent the risk of DVT after hip or knee replacement surgery, the suggested dose is 2.5 mg daily beginning 12 to 24 hours after the surgery is completed.
What drugs interact with aspirin vs. Eliquis?
- Aspirin is associated with several suspected or probable interactions that affect the action of other drugs. The following examples are the most common of the suspected interactions.
- NSAIDs may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.
- Aspirin may reduce the blood pressure lowering effects of blood pressure medications. This may occur because prostaglandins have a role in the regulation of blood pressure.
- When aspirin is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycoside antibiotics (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because their elimination from the body is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.
- Individuals taking oral blood thinners or anticoagulants, for example, warfarin, (Coumadin) should avoid aspirin because aspirin also thins the blood, and excessive blood thinning may lead to serious bleeding.
- Apixaban is a substrate of both CYP3A4 and P-gp. Inhibitors of CYP3A4 and P-gp increase exposure to apixaban and increase the risk of bleeding. Inducers of CYP3A4 and P-gp decrease exposure to apixaban and increase the risk of stroke and other thromboembolic events.
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Are aspirin and Eliquis safe to take while pregnant or breastfeeding?
- Aspirin is generally avoided during pregnancy because it may adversely affect the fetus. However, low aspirin doses have been safely used for the prevention of complications of pregnancy.
- Aspirin is excreted into breast milk and may cause adverse effects in the infant.
- There are no adequate studies in pregnant women. Use during pregnancy may increase the risk of bleeding during pregnancy and delivery. Apixaban should be avoided during pregnancy.
- It is not known if apixaban is excreted in human milk. Nursing mothers should discontinue apixaban or discontinue nursing.
Pain Management Resources
Aspirin and Eliquis (apixaban) are anticoagulants used to prevent blood clots (antithrombotics). Aspirin is also used to treat fever, pain, and inflammation in the body. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) and Eliquis is an anticoagulant (blood thinner).
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Related Disease Conditions
Deep Vein Thrombosis (DVT, Blood Clot in the Legs)
Deep vein thrombosis (DVT) is a blood clot in the deep veins, and can be caused by broken bones, trauma to a limb, immobility, medications, smoking, cancer, genetic predisposition, and cancer. Symptoms of a deep vein thrombosis in a leg are swelling, tenderness, redness, warmth, and pain. Treatments for DVT include medications and surgery.
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Stroke vs. Mini-Stroke (TIA) Differences
A stroke or "brain attack" occurs when a blood clot or artery ruptures within the brain. The rupture or clot causes brain cell damage or death. A mini-stroke (TIA, transient ischemic attack) is caused by brain cells that dysfunctional over a short period. Stroke and mini-stroke warning signs of stroke and mini stroke are the same, and include, speech problems, weakness, numbness, and facial droop. Side effects of stroke may be permanent and you may never regain full function of the parts of the body affected. Mini-stroke side effects usually resolve within minutes to a couple of days. A transient ischemic attack (mini-stroke) is a precursor for stroke because 40% of individuals who have a mini-stroke will have a stroke within a year. Treatment of stroke depends upon the type and parts of the body affected.
Pulmonary Embolism (Blood Clot in the Lung)
A pulmonary embolism (PE) occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate. Causes of pulmonary embolism include prolonged immobilization, certain medications, smoking, cancer, pregnancy, and surgery. Pulmonary embolism can cause death if not treated promptly.
Early Warning Signs and Symptoms of Stroke (FAST)
Stroke is a serious medical condition. If you think you or someone you know is having a stroke call 911 immediately. There are two main types of strokes, hemorrhagic and ischemic (the most common type). A hemorrhagic stroke occurs due to a blood vessel rupture in the brain. An ischemic stroke occurs when a blood clot becomes lodged in a blood vessel in the brain, which causes a loss of blood supply to the brain, possibly causing brain tissue death. FAST is an acronym that helps people identify stroke signs and symptoms so they can act fast and call 911. Face drooping, Arm weakness, and Speech difficulty are indicators that a person may be having a stroke and it is Time to seek emergency medical treatment. Additional signs and symptoms of stroke may include weakness, difficulty walking, blurred vision, dizziness, headache, confusion, difficulty speaking, and loss of sensation. Stroke is a major cause of death and disability in the U.S. Early identification and treatment of stroke helps reduce the risk of morbidity and mortality.
Blood Clots (in the Leg)
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for causes of blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Transient Ischemic Attack (TIA, Mini-Stroke)
When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. If the symptoms do not resolve, a stroke most likely has occurred. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Treatment depends upon the severity of the TIA, and whether it resolves.
Heart Attack vs. Stroke Symptoms, Differences, and Similarities
Heart attack usually is caused by a clot that stops blood flow supplying oxygen to an area of heart muscle, which results in heart muscle death. Stroke or "brain attack" is caused by a loss of blood supply to the brain (usually a blood clot) or by hemorrhagic stroke (bleeding within the brain), which results in brain tissue death. Both heart attack and stroke usually come on suddenly, produce similar symptoms, can be disabling, and can be fatal. The classic symptoms and warning signs of heart attack are different. Classic heart attack warning signs are chest pain or discomfort, shortness of breath, pain that radiates to the shoulders, back, arms, belly, jaw, or teeth, sweating, fainting, and nausea and vomiting. Moreover, woman having a heart attack may have additional symptoms like abdominal pain or discomfort, dizziness, clammy skin, and moderate to severe fatigue. The classic symptoms and warning signs that a person is having a stroke are confusion or loss of consciousness, sudden severe headache, speech problems, problems seeing out of one or both eyes, and numbness or weakness of only one side of the body. Moreover, a woman having a stroke may have additional warning symptom and signs like shortness of breath, disorientation, agitation, behavioral changes, weakness, nausea, vomiting, seizures, and hiccups. Recognition of stroke symptoms is vital for emergency treatment. The acronym "FAST" stands for recognition of Facial drooping, Arm weakness, Speech difficulty, and a Time for action. If you experience the symptoms heart attack or stroke (FAST) or see them develop in another person, then contact 911 immediately.
Stroke vs Aneurysm (Differences and Similarities)
A stroke or "brain attack" is caused because blood flow to an area of the brain has been cut off by a blood clot or by a weakened or damaged blood vessel (for example, head trauma). The damaged area of the brain dies, which results in loss of function like speech capabilities, muscle movement, or muscles of an extremity like an arm or leg is reduced or lost completely. An aneurysm is a weakness in an artery wall. This weakness in the wall causes the artery to widen or balloon out, and then they rupture or break open. A person with an brain aneurysm generally won't have any symptoms until it becomes a problem. The symptoms and signs are similar to a stroke.Symptoms and signs of a stroke include: Vision problems Severe headache with no known cause Loss of memory Trouble getting words out Trouble typing, texting, or other coordination problems Both the American Heart Association and the American Stroke Association recommend using the FAST system to recognize and treat strokes. If you think someone may be having a stroke, remember FAST! F - Facial drooping A - Arm weakness S - Speech difficulty T - time - DO NOT DELAY. Call 911.If you think someone is having a stroke or aneurysm call 911 immediately. Both conditions require medical treatment. The prognosis for both diseases depend on the extent of the damage to the brain and any other affected areas of the body.
Stroke is the third leading killer in the United States. Some of the warning signs of stroke include sudden confusion, trouble seeing with one or both eyes, dizziness, loss of balance, and more. Stroke prevention and reatable risk factors for stroke include lowering high blood pressure, quit smoking, heart disease, diabetes control and prevention.
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