Navigating the Legalities: Is it illegal to get Eliquis from Canada?

October 9, 2025 •

3 min read

While federal law technically prohibits the personal importation of prescription drugs from abroad, the FDA exercises 'enforcement discretion' under specific circumstances, prompting many to question: Is it illegal to get Eliquis from Canada? With Canadian drug prices often significantly lower, this has become a compelling option for many patients.

Quick Summary

Importing Eliquis from Canada for personal use exists in a legal gray area, with federal law technically prohibiting it but the FDA generally allowing small, non-commercial quantities under specific conditions, particularly when purchased from certified online pharmacies with a valid prescription. Safety and authenticity remain key concerns.

Key Points

FDA's Enforcement Discretion: The FDA exercises 'enforcement discretion,' which means that while personal importation is technically illegal, it is not actively enforced for small, personal quantities of drugs like Eliquis, especially from certified sources.
Legitimate Sources are Crucial: It is critical to use Canadian online pharmacies certified by the Canadian International Pharmacy Association (CIPA) or IPABC to ensure you receive genuine, safe medication.
Requires a Valid Prescription: Reputable Canadian pharmacies will always require a valid prescription from a licensed physician, mirroring standard US pharmacy procedures.
Adhere to the 90-Day Supply Limit: The FDA's informal policy generally limits personal imports to a 90-day supply to demonstrate it's for non-commercial use.
Beware of Counterfeit Drugs: Unverified or 'rogue' online pharmacies pose a significant risk of selling counterfeit, substandard, or mislabeled medication, which can be dangerous.
Significant Cost Savings Available: Canadian drug price regulations result in substantial savings, often 70-85%, on Eliquis and its generic equivalent compared to US retail prices.
Insurance Coverage is Unlikely: Most US insurance plans will not cover prescriptions filled by international pharmacies, though cost savings often outweigh this.

Understanding the Complex Legal Framework

Under the Federal Food, Drug, and Cosmetic Act, it is technically illegal for individuals to import prescription drugs into the United States for personal use. This regulation exists because the U.S. Food and Drug Administration (FDA) cannot guarantee that foreign-sourced drugs meet the same safety and efficacy standards as those sold domestically. However, the application of this law is complicated by the FDA's policy of "enforcement discretion".

The FDA's Enforcement Discretion Policy

The FDA's personal importation policy outlines circumstances where the agency typically does not object to the importation of unapproved drugs for personal use. This is why many Americans have been able to order medications from Canadian pharmacies without issue. Key criteria for this discretion include that the medication is for a serious condition without effective domestic treatment, is not known to pose unreasonable health risks, is limited to a 90-day supply, is for personal use, is not commercially promoted, and includes physician contact information. While Eliquis is available in the US, the FDA generally does not enforce the ban for small, personal quantities from reputable sources.

Importing Eliquis: Weighing Safety and Cost

The main reason Americans purchase Eliquis (apixaban) from Canada is the lower cost, largely due to Canada's drug price regulations.

How to Safely Order from Canadian Pharmacies

To safely import Eliquis, use online pharmacies certified by the Canadian International Pharmacy Association (CIPA) or the International Pharmacy Association of British Columbia (IPABC). These pharmacies require a valid prescription and adhere to safety standards. Always verify the pharmacy's credentials, ensure the website is secure, and limit your order to a 90-day supply to comply with FDA guidelines.

Risks of Using Unsafe Pharmacies

Using unverified online pharmacies carries significant risks, including receiving counterfeit drugs, substandard quality medication, incorrect dosages, and a lack of regulatory oversight.

Cost Comparison: US vs. Canadian Eliquis

The table below shows the estimated price differences for a 30-day supply of Eliquis (60 tablets) between US retail pharmacies and certified Canadian online pharmacies.


Item	Average US Retail Price (Without Insurance)	Average Canadian Online Pharmacy Price	Potential Savings
Brand-Name Eliquis	$550–$600	$100–$150	70–80%
Generic Apixaban	$400–$450	$70–$100	75–85%

Note: Prices are estimates and may vary. They do not include US copay cards or patient assistance programs.

The Future of Drug Importation: State-Level Programs

Some US states are exploring state-sponsored drug importation programs from Canada, authorized under Section 804 of the Federal Food, Drug, and Cosmetic Act. Florida received FDA authorization for such a program in early 2024, but these initiatives are not yet fully operational for consumers. Currently, personal importation relies on the FDA's enforcement discretion and the use of certified online pharmacies.

Conclusion: Navigating the Legal and Safety Landscape

While personal importation of Eliquis from Canada is technically illegal, the FDA's enforcement discretion makes it a practical option for many Americans seeking lower costs. The key is to exclusively use certified Canadian online pharmacies that require a valid prescription. By adhering to safe practices, understanding the legal nuances, and being aware of the risks associated with unverified sources, patients can potentially achieve significant cost savings. Consulting a healthcare provider and exercising caution are essential for both financial benefit and personal safety.

Further Information: For detailed information on the FDA's policy on personal drug importation, visit the official FDA Personal Importation Policy.

Frequently Asked Questions

To verify a Canadian online pharmacy's legitimacy, look for certification seals from organizations like the Canadian International Pharmacy Association (CIPA) or the International Pharmacy Association of British Columbia (IPABC). You can also cross-reference the pharmacy's name on the respective organization's website.

While it is possible for your shipment to be flagged by Customs and Border Protection, it is unlikely if the medication is a maintenance drug like Eliquis, is for personal use, and is limited to a 90-day supply. The FDA prioritizes seizing controlled substances and high-risk shipments, not typically those from certified Canadian pharmacies.

Yes, reputable Canadian online pharmacies, particularly those certified by CIPA or IPABC, will accept a valid prescription from a US-licensed healthcare provider. They may work with you or your doctor to transfer the prescription for a refill.

Yes, generic versions of Eliquis (apixaban) have been approved and available in Canada since 2022 and are available through Canadian online pharmacies, often at even lower prices than the brand-name version.

Eliquis is cheaper in Canada primarily because of government price regulation. Canada's Patented Medicine Prices Review Board (PMPRB) controls drug costs, while the US market lacks similar controls, leading to significantly higher prices.

You should immediately avoid any online pharmacy that offers to sell you Eliquis without a valid prescription. This is a major red flag for an illegal, unsafe, or 'rogue' operation that could sell counterfeit or dangerous drugs.

Federal law technically prohibits importing unapproved drugs, which can include those from Canada, even if they are foreign versions of FDA-approved drugs. However, the FDA's 'enforcement discretion' policy means that, for personal quantities, enforcement is not typically pursued.