Eliquis and omega 3 fish oil contraindication

On another topic it was mentioned that Eliquis and omega 3 fish oil are contraindicated? Is that correct? What is the advice regarding taking both of those. Is it OK to simply take them at separate times in the day?

Thank you

Everyone differs in how their body processes out the meds. I don’t think there is a set yes or no answer. Ask a pharmacist who knows what drugs and supplements you currently are taking.

[www.aafp.org]
This sums it up from the above link (repeat link from another thread if you missed it) :
“ This is because drug metabolism via CYP450 enzymes exhibits genetic variability (polymorphism) that influences a patient's response to a particular drug.”

“Interactions between drugs. (from drugs.com):
Moderate
omega-3 polyunsaturated fatty acids apixaban
Applies to: Omega-3 (omega-3 polyunsaturated fatty acids) and Eliquis (apixaban)
MONITOR: Omega-3 fatty acids (e.g., fish oil) may potentiate the pharmacologic effects of anticoagulants and other drugs that affect hemostasis such as platelet inhibitors, thrombin inhibitors, thrombolytic agents, dextran, and nonsteroidal anti-inflammatory drugs (NSAIDs). The exact mechanism of interaction is unknown. Omega-3 fatty acids may possess mild antiplatelet and hypocoagulant activities. In some studies, these substances have been shown to reduce thrombin generation and plasma levels of fibrinogen, prothrombin, and coagulation factors V, VII, and X. Prolongation of bleeding time has been demonstrated, although it did not exceed normal limits and did not produce clinically significant bleeding. The interaction was suspected in a case report of a 67-year-old woman treated with warfarin for 1.5 years who exhibited an increase in INR from 2.8 the previous month to 4.3 approximately one week after doubling her fish oil dosage from 1000 to 2000 mg/day. Prior to the increase, her INR had been stable and therapeutic for 5 months on warfarin 1.5 mg/day. The patient was advised to reduce her fish oil consumption to 1000 mg/day, while her warfarin dose was withheld for one day and then reduced to 1 mg alternating with 1.5 mg per day. Eight days later, her INR was subtherapeutic at 1.6, so the warfarin dosage was increased back to 1.5 mg/day. The patient's INR subsequently returned to therapeutic range.

MANAGEMENT: In general, patients should consult a healthcare provider before taking any herbal or nutritional supplements. Patients using omega-3 fatty acids in combination with anticoagulants or other drugs that affect hemostasis should be advised of the potential for increased risk of bleeding complications.”

thank you

I have been on Eliquis 5 mg b.i.d. for 11 days. I know I took my tsp of cod liver oil today. For some reason today, I have felt extremely tired & dizzy. I have an intracochlear schwannoma (deep inner ear tumor that affects the nerves/balance/hearing - made me deaf in that ear & for a couple of yrs I also always have a swinging feeling in my head from having this tumor, tho all that notwithstanding, I have pretty good balance, but I still feel swoony in the head). Today everything is increased - why?

Anyway now I am wondering if the Eliquis thinning my blood is making me more lightheaded & swingy in the head feeling. Also bowel movements have increased and are soft and blackish - not so before starting this drug. I know black stools might be from blood. Not sure what is going on. I took Xarelto a few yrs ago & don't think I had this stuff. I switched ins plans so I could take Eliquis since you do not have to eat when you take it & ppl say it is a bit better than Xarelto.

Do these sound like side effects from Eliquis? Can I take my cod liver oil too? Any thoughts on all this? I hear one only takes the 2.5 mg dose if they are over 80 y/o & perhaps under 105 lb. I weigh 107 usually, but am weighing 105 now. I am only 72 y/o.

I doubt the ear issues have anything to do with the Eliquis, but keep an eye on the soft, dark stools. If they appear really black and tarry, talk to your doc. Doesn't need to be an EP, just your PCP will be fine.

And one teaspoon of cod liver oil per day is a pretty tiny amount. That would probably be less than the average person in certain countries consumes per day from their normal diet, so I'm skeptical it could be an issue. But unless it's really important to you, easy enough to make sure. Just stop it for a week to see if anything changes.

Thank you, Carey.