Apixaban, also known by the brand name Eliquis, is an anticoagulant drug that acts as a blood thinner for people suffering from a common cardiac arrhythmia called atrial fibrillation (AF). This prescription medication helps to prevent the blood from clotting, as clotting can disrupt blood flow to the brain and lead to a potentially life-threatening stroke.
Even when the medication is taken as directed through a legitimate and necessary medical prescription under the direction of a trained medical professional, Eliquis is not without serious possible side effects and risk factors. The Institute for Safe Medication Practices (ISMP) listed oral anticoagulant drugs as having some of the biggest safety concerns of all drug types for 2016, as reported by Quarterwatch Reports.
Apixaban and other novel oral anticoagulant (NOAC) medications can cause excessive internal bleeding that may be irreversible and can also increase the odds for developing a spinal hematoma that can lead to permanent or long-term paralysis. There is no specific antidote approved to reverse the effects of NOVAC medications currently.
Another significant potential hazard is an actual increased risk for stroke when stopping the medication, the distributors of Eliquis, Bristol-Myers Squibb (Pfizer), warn. The American College of Cardiology (ACC) publishes that apixaban should not be stopped suddenly or without medical intervention and supervision.
Apixaban Withdrawal Symptoms
Withdrawal is what can happen when a person stops taking a medication that the brain and body have become at least somewhat dependent on. When someone takes a psychoactive drug, chemical changes are made in the brain, altering the normal chemical balance as well as the way that neurotransmitters are sent and received. With repeated use and interaction of the drug on the brain and body, the brain can actually change the way it transmits, produces, and reabsorbs its chemical messengers.
Apixaban serves as a direct Xa inhibitor in the bloodstream, thinning the blood and changing the way blood clots form by blocking the action of the natural substance in the bloodstream, the U.S. National Library of Medicine (NLM) explains. If the drug is suddenly stopped after being taken for a period of time, the blood can clot too much, causing a potential stroke.
Other possible withdrawal symptoms from Eliquis include:
- Mood swings
- Sleep issues
- Heart palpitations
- Feeling lightheaded
- Weakness in the legs and arms
- High blood pressure
- Dry mouth
- Easy bruising
- Nausea and stomach upset
Apixaban Withdrawal Timeline
The prescribing information for Eliquis reports that the medication has a half-life of 12 hours when taken orally as directed. This means that the drug can remain active in the bloodstream for about 24 hours. Once a drug stops being active in the body, withdrawal side effects can begin.
Apixaban withdrawal will generally start within a day or so after the last dose. Within the first few days of withdrawal, symptoms will peak and begin to dissipate within five days. Emotional disturbances and sleep difficulties can continue beyond the first week; however, most of the physical side effects will only last about three to five days on average.
Metabolism and other biological factors, including the presence of a medical or mental health condition, can impact withdrawal severity and duration. Environmental factors, including stress levels and a stable home environment, can also impact the withdrawal timeline.
Withdrawal intensity and duration are also influenced by how dependent the brain and body are on Eliquis. This can be impacted by how much of the drug a person takes with each dose, how long they have been taking it for, and how often they take it. Abuse of apixaban (taking it in a manner other than as intended), can also complicate and exacerbate possible withdrawal symptoms. For example, crushing Eliquis and then snorting the drug changes the way it is metabolized, sending the drug straight into the bloodstream and rapidly across the barrier between the blood and the brain. This can increase drug dependence and therefore influence the withdrawal timeline and intensity of the symptoms.
Mixing apixaban with other drugs, medications, or alcohol raises the odds for an adverse reaction during withdrawal. Other drugs can also act as blood thinners, which can increase the risk for a potentially fatal overdose. It can complicate withdrawal symptoms and impact the timeline. Combining other medications or drugs with Eliquis can also add in other possible withdrawal symptoms, and this needs to be considered during detox.
The Importance of Medical Detox for Eliquis Withdrawal
Detox involves drugs processing out of the brain and body. There are several “home detox” kits out there on the market. These kits are particularly unsafe for a medication such as Eliquis due to the potential for a serious and life-threatening reaction when the medicine is stopped suddenly.
Instead of stopping apixaban “cold turkey,” medical professionals will often introduce a tapering schedule instead. This means that the dosage is lowered slowly over a set and controlled period of time to avoid the sudden chemical change in the body that can occur with rapid discontinuation of a drug.
Eliquis can be weaned off slowly. The dosage is lowered a little bit at a time over several days or weeks to minimize withdrawal symptoms and lessen the risk for blood clotting and stroke. Typically, Eliquis is administered in 2.5 mg or 5 mg doses twice a day. During a taper, this dosage may be lowered by a specific percentage that is unique to the individual each day until it can safely be discontinued completely. Eliquis may also be switched out with a different blood thinner or anticoagulant medication during detox.
Medical detox offers the highest standard of care during withdrawal. A medical detox program provides a secure, calm, and stable environment as well as medical care, supervision, and monitoring. Medications can be administered and managed by medical professionals to control specific symptoms of withdrawal. Supportive care and continual encouragement are highly beneficial to healing during medical detox.
Medical detox programs can address co-occurring medical and mental health concerns in an integrated and seamless manner as well a team of trained professionals all work together to improve quality of life. Holistic methods, such as chiropractic care, massage therapy, spa treatments, and nutritional supplements, can be highly beneficial to healing during medical detox.