Eliquis Brain Bleed Risk - Signs, Symptoms & Emergency Response

Assessing the Risk of Brain Bleeding as a Side Effect of Eliquis

Eliquis (apixaban) is a popular anticoagulant (blood thinner) medication used to treat and prevent blood clots, strokes, and other cardiovascular conditions. However, like all blood thinners, Eliquis also comes with an increased risk of excessive bleeding as a potential side effect.

Brain bleeds are one dangerous type of bleeding that can occur with anticoagulant use. While the chance of experiencing a major brain hemorrhage on Eliquis is relatively low, this severe complication can lead to lasting neurological damage or even death when it does happen.

How Eliquis Works to Prevent Blood Clots

Eliquis works by a factor Xa inhibitor mechanism of action. It blocks a key enzyme (factor Xa) involved in the blood clotting process. This prevents the formation of rigid fibrin threads that bind platelets together into an obstructive clot.

However, tampering with the delicately balanced coagulation cascade also hinders the bodys ability to stop bleeding efficiently. This may lead to potential bleeding issues in some patients taking Eliquis or related factor Xa inhibitors.

Types of Brain Bleeds

There are several types of intracranial hemorrhages that can occur:

• Hemorrhagic Stroke - Bleeding within the brain tissue itself
• Subdural Hematoma - Bleeding between the surface of the brain and its outermost covering
• Subarachnoid Hemorrhage - Bleeding between the brain and the inner layer of tissue surrounding it

These involve dangerous buildups of blood applying pressure to delicate neurological structures. The complications worsen as more bleeding occurs, damaging brain function.

What is the Risk of Brain Bleeding on Eliquis?

All anticoagulant medications list intracranial hemorrhage as a potential adverse effect. However, clinical trials suggest the rates of brain bleeding events in patients taking Eliquis (apixaban) appear fairly low.

Eliquis vs Warfarin Brain Bleed Risks

Compared to the older anticoagulant warfarin, analysis shows Eliquis results in 52% fewer hemorrhagic strokes and 68% fewer hematomas. This indicates it likely induces less severe bleeding issues overall.

One large study found intracranial bleeding rates on apixaban were just 0.33% per year - much lower than the 0.80% annual risk determined for warfarin. The newer drug apixaban seems to preserve more of the bodys natural clotting ability to prevent excess bleeding.

Factors That Increase Danger of Brain Bleeds

Those most vulnerable to cerebral hemorrhaging while taking apixaban (Eliquis) include:

• Elderly patients over age 75
• People with low body weight
• Those with a history of stroke or other bleeding disorders
• Patients taking other medications that inhibit clotting
• Individuals who drink heavily, impacting liver metabolism

Additional risk factors like high blood pressure, trauma injuries, specific medical procedures, or headaches also raise concerns in patients taking apixaban.

Signs and Symptoms of a Brain Bleed

Being aware of bleeding red flags allows prompt medical care to minimize permanent damage from a potentially deadly brain hemorrhage. Be vigilant about these possible signs of intracranial bleeding:

Sudden Severe Headaches

Sudden intense head pain different from your usual headaches is the classic early warning. This may indicate blood leaking and applying pressure inside the skull. The pain often starts very abruptly and continues intensifying.

Dizziness and Loss of Balance

Feeling lightheaded and having difficulty maintaining equilibrium can signal bleeding impacting brain tissue controlling coordination. This may accompany or follow after a severe headache.

Vision Changes

Vision blurring, double vision, or loss of sight indicate bleeding near cranial nerves controlling eye functioning. Vision tends to fade as blood spreads through brain matter towards the back.

Nausea and Vomiting

Intracranial pressure from blood buildup often triggers nausea and vomiting reflexes. These signs usually coincide with the headaches onset.

Confusion and Altered Consciousness

As bleeding increases within the brain, patients often experience progressive confusion, memory loss, disorientation, behavior changes, seizures, weakness, and loss of consciousness. Damage can quickly become irreversible once blood presses on conscious control centers.

What to Do if a Brain Bleed is Suspected

At the very first symptoms suggesting a possible brain hemorrhage like severe sudden headache or vision changes - immediately call emergency services or go to your nearest ER. Stress you take the anticoagulant Eliquis and describe all other signs you are experiencing.

Rapid specialized emergency diagnosis and treatment are essential for limiting damage after a dangerous bleed. Doctors can administer drugs that counteract Eliquis to restore normal clotting ability to stop further blood loss as quickly as possible.

Emergency Treatment Options

Medical teams have several interventions for controlling brain bleed complications:

• IV reversal agents - Rapidly neutralize Eliquis activity in the body
• Controlled venting - Relieve pressue by draining blood trapped within skull
• Endovascular coiling - Seal ruptured weak blood vessels internally
• Neurosurgery - Clean out large bleeds surgically if localized
• ICU monitoring - Watch for seizures, swelling, circulation issues
• Rehabilitation - Regain neurological function after significant injury

Anti-clotting therapy eventually resumes once bleeding is resolved and the patient stabilizes. But urgent medical de-escalation helps mitigate lasting impairment or threats to life after an acute hemorrhagic event.

Lowering Brain Bleed Risks on Eliquis

Follow all instructions from your doctor closely to use Eliquis safely and minimize chances of a major bleeding complication like an intracranial hemorrhage requiring emergency intervention.

Take Eliquis as Directed

Carefully follow prescribed Eliquis doses without skipping or doubling up. Report any missed doses to determine if an adjustment is advised before continuing normally. This maintains the correct blood concentration for preventing clots without allowing excessive anticoagulant activity.

Monitor for Side Effects

Watch closely for early signs of bleeding issues like unexplained bruising, nosebleeds, bleeding gums, heavier menstrual flow, red or brown urine, or black tarry stools. Promptly report these or any unusual symptoms to your physician.

Avoid Other Blood Thinners

Using other non-prescription medications, herbs or supplements with blood thinning effects in addition to Eliquis can dangerously intensify bleeding risks. Common products to avoid include garlic, ginkgo, ginseng, fish oil, and NSAIDs like aspirin or ibuprofen unless explicitly approved by your doctor.

Let all healthcare providers know you take Eliquis before having any medical, surgical or dental procedures done to allow special precautions avoiding bleeding issues.

The Takeaway

While the possibility exists, Eliquis only rarely causes catastrophic intracranial hemorrhaging compared to other older blood thinners when taken correctly under medical guidance. Still, seek emergency help at the very first signs of a potential brain bleed to avoid severe, lasting impairment or death.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.