Can You Take Eliquis with Miralax? A Guide to Safety and Interactions

October 12, 2025 •

3 min read

According to drug interaction checkers, no direct interactions have been found between Eliquis (apixaban) and Miralax (polyethylene glycol 3350) [1.2.1, 1.2.2]. This article explores the question, 'Can you take Eliquis with Miralax?', and discusses how to safely manage constipation while on anticoagulant therapy.

Quick Summary

Current data shows no direct drug interaction between Eliquis (apixaban) and Miralax [1.2.1, 1.3.1]. However, it is vital to consult a healthcare provider before combining them to ensure safety and manage constipation effectively while on a blood thinner.

Key Points

No Direct Interaction: Current drug databases show no direct pharmacological interaction between Eliquis (apixaban) and Miralax (polyethylene glycol 3350) [1.2.1, 1.3.1].
Consult Healthcare Provider: Always consult your doctor before taking Miralax or any new OTC medication while on Eliquis to ensure safety [1.2.2].
Eliquis is a Blood Thinner: Eliquis works by inhibiting Factor Xa to prevent blood clots, and its primary side effect is an increased risk of bleeding [1.6.2, 1.6.3].
Miralax is an Osmotic Laxative: Miralax treats constipation by drawing water into the intestines to soften stool [1.7.1].
Indirect Considerations: While not a direct interaction, severe diarrhea from any laxative could theoretically impact drug absorption [1.4.5].
Avoid NSAIDs: Never take laxatives or other products containing NSAIDs (like aspirin) with Eliquis, as they increase bleeding risk [1.2.3].
Lifestyle First: Before using laxatives, try managing constipation with increased fiber, water intake, and exercise [1.5.3].

Understanding Eliquis and Its Function

Eliquis, with the active ingredient apixaban, is a prescription anticoagulant, commonly known as a blood thinner [1.6.2]. It is classified as a direct-acting oral anticoagulant (DOAC) that works by inhibiting Factor Xa, a key protein involved in the blood clotting process [1.6.2]. By blocking this factor, Eliquis reduces the blood's ability to form dangerous clots, which is crucial for:

Preventing stroke in patients with non-valvular atrial fibrillation (AFib) [1.6.1].
Treating deep vein thrombosis (DVT), which are clots typically in the legs [1.6.1].
Treating pulmonary embolism (PE), which are clots in the lungs [1.6.1].
Preventing DVT and PE after hip or knee replacement surgery [1.6.1].

The most significant risk associated with Eliquis is bleeding [1.6.5]. This can range from minor issues like bruising more easily or nosebleeds to severe, life-threatening internal bleeding [1.6.1, 1.6.3]. Because of this risk, patients are advised to inform all their healthcare providers, including dentists, that they are taking Eliquis before any medical procedures [1.6.5].

What is Miralax and How Does it Work?

Miralax is an over-the-counter (OTC) laxative used to treat occasional constipation [1.7.2]. Its active ingredient is polyethylene glycol 3350 (PEG 3350) [1.7.2]. Miralax is an osmotic laxative, which means it works by drawing and retaining water in the colon [1.7.1, 1.7.3]. This process softens the stool, making it easier to pass and promoting a bowel movement, typically within 1 to 3 days of use [1.7.1, 1.7.2]. Common side effects can include bloating, gas, and nausea [1.7.2, 1.7.3].

The Core Question: Is There an Interaction?

Drug interaction databases report that no direct interactions have been found between apixaban (Eliquis) and polyethylene glycol 3350 (Miralax) [1.2.1, 1.3.1]. This suggests that taking them together is not expected to cause a direct pharmacological conflict. However, these resources always include the important disclaimer that the absence of a reported interaction does not definitively mean none exists, and consultation with a healthcare provider is essential [1.2.2].

While a direct chemical interaction is not noted, there are indirect considerations. For instance, Miralax works by speeding up how quickly contents move through the digestive system [1.4.5]. Theoretically, this could affect how well other medications are absorbed, though this has not been specifically reported with Eliquis [1.4.5]. Additionally, a potential side effect of any laxative can be diarrhea. Severe or prolonged diarrhea could potentially alter the absorption of oral medications and lead to dehydration [1.3.7].

Managing Constipation Safely While on Eliquis

Constipation can be a concern for many individuals, and managing it while on a potent medication like Eliquis requires a careful approach to avoid complications, particularly those related to bleeding [1.5.1]. Straining during bowel movements can increase blood pressure and the risk of hemorrhoids, which can bleed [1.5.6].

Lifestyle and Dietary Approaches First:

Increase Fiber Intake: Adding fiber-rich foods like fruits, vegetables, beans, and whole grains can help soften stool [1.5.3].
Stay Hydrated: Drinking plenty of water is crucial, as it helps fiber work more effectively and softens stool [1.5.3, 1.5.4].
Regular Exercise: Physical activity can help stimulate bowel function [1.5.3].

When to Consider Laxatives: If lifestyle changes are not sufficient, an OTC laxative might be considered. Polyethylene glycol (Miralax) is often recommended as a safe option for many patients, including the elderly [1.5.2, 1.5.5]. It's crucial, however, to avoid any laxatives or other OTC products that contain NSAIDs (like aspirin), as these can independently increase the risk of bleeding when taken with Eliquis [1.2.3, 1.5.7]. Always check the labels of any OTC product.

Comparison Table: Eliquis vs. Miralax


Feature	Eliquis (Apixaban)	Miralax (Polyethylene Glycol 3350)
Drug Class	Anticoagulant (Factor Xa Inhibitor) [1.6.2]	Osmotic Laxative [1.7.3]
Primary Use	Prevent/treat blood clots, stroke [1.6.1]	Treat occasional constipation [1.7.2]
Mechanism	Blocks Factor Xa to reduce blood clotting [1.6.2]	Draws water into the colon to soften stool [1.7.1]
Prescription?	Prescription only [1.6.1]	Over-the-counter (OTC) [1.7.2]
Main Side Effect	Bleeding, bruising [1.6.3]	Bloating, gas, nausea [1.7.2]

Conclusion

Based on available data, there is no known direct drug interaction between Eliquis and Miralax [1.2.1]. This makes Miralax a potentially suitable choice for managing constipation in patients taking Eliquis, especially when compared to products containing NSAIDs [1.2.3]. However, the most critical step for any patient on a blood thinner is to consult their healthcare provider before starting any new OTC medication, including laxatives. A doctor can provide personalized advice, confirm the absence of risk based on your complete health profile, and rule out other causes of constipation. Never stop taking Eliquis without your doctor's instruction, as this can increase your risk of blood clots [1.6.3].

For more detailed information on Eliquis, you can visit the official FDA drug label information.

Frequently Asked Questions

Generally, it can be safe, but you must choose the right one. Osmotic laxatives like Miralax (polyethylene glycol 3350) are often considered safe as they have no direct interaction with Eliquis [1.2.1, 1.5.2]. However, you must avoid any products containing NSAIDs, such as aspirin, which increase bleeding risk [1.2.3]. Always consult your doctor first.

The main and most serious risk of taking Eliquis is bleeding [1.6.5]. This can range from minor bleeding, like nosebleeds or easy bruising, to severe and potentially fatal bleeding [1.6.1, 1.6.3].

Miralax is an osmotic laxative. It works by attracting and holding water in your colon, which softens the stool and makes it easier to have a bowel movement [1.7.1, 1.7.3].

While Miralax can speed up the transit of contents through the digestive system, it has not been specifically reported to affect the absorption of Eliquis [1.4.5]. However, severe diarrhea could theoretically alter drug absorption, which is why medical guidance is important [1.3.7].

First, try increasing your intake of dietary fiber and water, and engage in regular physical activity [1.5.3]. If these measures don't work, talk to your doctor about using a safe OTC laxative like Miralax [1.5.2, 1.5.5].

Yes, you should avoid any laxative or antacid product that contains nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen, as these significantly increase your risk of bleeding when combined with Eliquis [1.2.3, 1.5.7].

Yes. If you are taking a prescription medication like Eliquis, you should always inform your doctor before starting any new over-the-counter drugs, supplements, or herbs, including Miralax [1.2.1].