Can Eliquis be taken with a statin?: Navigating the Combination Safely

October 12, 2025 •

3 min read

According to the U.S. Preventive Services Task Force, clinicians often prescribe statins to adults with elevated cardiovascular risk factors, with many of these individuals also requiring an anticoagulant like Eliquis. While co-prescribing is common, a mild drug interaction can occur when Eliquis is taken with certain statins, making informed management essential for patient safety.

Quick Summary

Taking Eliquis and a statin concurrently is generally safe under a doctor's supervision. A mild interaction can increase Eliquis levels with certain statins, but this does not typically necessitate dose changes.

Key Points

Generally Safe Combination: Taking Eliquis and a statin together is widely considered safe, but it requires a doctor's supervision to manage effectively.
Mild Drug Interaction: A mild interaction can occur with certain statins (like atorvastatin) due to shared metabolic pathways, which can slightly increase Eliquis levels.
Monitoring is Key: Patients on this combination should be monitored for signs of increased bleeding or bruising, though the risk is typically low.
Open Communication with Doctor: Inform your healthcare provider about all medications and supplements to ensure a safe and tailored treatment plan.
Different Statins, Different Risks: Statins like rosuvastatin and pravastatin, which use different metabolic enzymes, pose a lower risk of interaction with Eliquis compared to atorvastatin and simvastatin.
Avoid Grapefruit Juice with Some Statins: Grapefruit juice can affect statin metabolism, increasing side effects, and should be avoided or limited, especially with atorvastatin and simvastatin.
Never Stop Medication Abruptly: Do not stop taking either medication without consulting your doctor, as this can increase your risk of cardiovascular events.

Managing cardiovascular health often involves a combination of medications to address different risk factors. Eliquis (apixaban) is a powerful anticoagulant used to prevent blood clots, while statins are cholesterol-lowering drugs used to reduce the risk of heart disease. Due to overlapping treatment needs, it is common for patients to be prescribed both. Understanding the potential for a drug interaction and how to safely manage this combination is crucial.

The Mild Interaction Between Eliquis and Statins

A mild pharmacokinetic interaction can occur when Eliquis and certain statins, particularly atorvastatin, are taken together. This interaction happens because both medications are processed by the same liver enzyme system, CYP3A4, and transported by P-glycoprotein (P-gp). This shared metabolic pathway can lead to a slight increase in Eliquis blood levels, typically between 10-20%. However, this increase is generally not considered significant enough to require an Eliquis dose adjustment for most patients. The benefits of using both medications to prevent blood clots and lower cholesterol usually outweigh the minimal risks associated with this interaction.

Which Statins Interact with Eliquis?

The likelihood and degree of interaction depend on how each specific statin is metabolized. Atorvastatin and Simvastatin are primarily metabolized by CYP3A4, the same enzyme system used by Eliquis. Rosuvastatin and Pravastatin are metabolized by different pathways, such as CYP2C9, resulting in a lower risk of significant interaction with Eliquis compared to statins metabolized by CYP3A4.

Table: Comparison of Eliquis and Statin Interactions


Statin (Brand Name)	Primary Metabolic Pathway	Interaction Potential with Eliquis	Clinical Significance
Atorvastatin (Lipitor)	Primarily CYP3A4, P-gp	Mild	Minor blood level increase of Eliquis; no dose change typically needed.
Simvastatin (Zocor)	Primarily CYP3A4, P-gp	Mild to Moderate	Potential for increased Eliquis exposure; monitoring recommended, though dose change is unlikely.
Rosuvastatin (Crestor)	Primarily CYP2C9	Minimal	Lower potential for interaction compared to CYP3A4-metabolized statins.
Pravastatin (Pravachol)	Primarily CYP3A4, P-gp, and others	Minimal	Lower potential for interaction compared to CYP3A4-metabolized statins.
Lovastatin (Mevacor)	Primarily CYP3A4, P-gp	Mild to Moderate	Similar profile to simvastatin; monitoring recommended.

Important Safety Measures for Co-Prescribing

Even though the interaction is usually not clinically significant, careful management is essential. Your healthcare provider will use their expertise to determine the best course of action for your individual health needs.

Monitoring and Symptoms to Watch For

Patients taking both medications should be aware of the signs of increased bleeding risk, which is a primary concern with anticoagulants. Symptoms can include unusual bleeding, bruising, gastrointestinal bleeding, or neurological symptoms.

Patient-Doctor Communication

Effective communication with your healthcare team is vital for safe medication use. Always inform your doctors, dentists, and pharmacists about all medications and supplements. Attend regular follow-ups, report any unusual symptoms, and inform your provider before medical procedures.

Lifestyle Adjustments

Patients taking atorvastatin or simvastatin should limit or avoid grapefruit juice. Reducing alcohol intake is also advisable as both Eliquis and alcohol can increase bleeding risk.

Conclusion: Safe and Effective Co-Prescribing with Proper Oversight

Combining Eliquis and a statin is generally safe and necessary for managing cardiovascular conditions. While a mild interaction exists between Eliquis and certain statins like atorvastatin and simvastatin due to shared metabolic pathways, this typically does not require dose adjustments and the benefits of preventing heart attacks and strokes generally outweigh the low risk of interaction. Always consult a healthcare provider for personalized advice and management. More information can be found in the official prescribing information for Eliquis from {Link: Bristol Myers Squibb https://packageinserts.bms.com/pi/pi_eliquis.pdf}.

Frequently Asked Questions

Most statins can be taken with Eliquis, but some, like atorvastatin and simvastatin, have a mild drug interaction due to shared metabolic pathways. Statins like rosuvastatin and pravastatin have a lower potential for this specific interaction.

The primary risk is an increased potential for bleeding, although the interaction is generally mild and not considered clinically significant enough to cause major issues for most patients. Patient monitoring is key to detect any unusual bleeding or bruising.

A patient may need both to manage multiple cardiovascular risk factors. Eliquis prevents dangerous blood clots from forming, while a statin lowers cholesterol to reduce the risk of heart attacks and strokes.

In most cases, the mild interaction does not necessitate a dose adjustment for either medication. The potential benefits of the combination usually outweigh the minimal risk.

While Eliquis increases bleeding risk in general, the addition of a statin does not significantly amplify this for most people. However, you should always be vigilant for signs of bleeding and discuss any concerns with your doctor.

It is important to follow your doctor's instructions for missed doses. For Eliquis, take the missed dose as soon as you remember on the same day. For statins, take the missed dose when you remember unless it is almost time for your next dose.

You should limit or avoid grapefruit juice, especially if taking statins like atorvastatin or simvastatin, as it can increase statin levels in the blood. Alcohol can also increase bleeding risk with Eliquis and should be consumed in moderation.