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Paxlovid while on Eliquis

Posted by frankangelo 
Paxlovid while on Eliquis
September 24, 2022 12:30AM
I have been exposed to covid but have not tested positive or have any symptoms as of yet. Looking ahead, if I do get Covid, I'm wondering if I should use paxlovid. [I am 75 yo and that is my major risk factor for severe covid] I am vaccinated and have two boosters. My afib is in remission since my ablation and I am taking apixaban 5 mg BID. I understand there might be a drug interaction between Apixaban and paxlovid. Has anyone on this forum used paxlovid while being on Apixaban? I am skeptical about the drug since it was approved after only one trial which was only with unvaccinated patients. At the same time I don't want to fail to protect myself adequately. All comments welcomed.
Re: Paxlovid while on Eliquis
September 24, 2022 02:17PM
I don't see a contraindication worth noting at just this one site. Perhaps a few more references would help to set you at ease?

[www.drugs.com]
Re: Paxlovid while on Eliquis
September 24, 2022 03:21PM
I got covid in August and wished I had the opportunity of getting the drug. I actually wanted the antibodies IV too but that wasn’t available to me. I have had a near daily to mult daily flutter marathon since. It really affected my heart. I hope you don’t get covid and if you do it’s mild and not symptomatic.
Re: Paxlovid while on Eliquis
September 24, 2022 05:48PM
The Eliquis dosage probably needs to be reduced while you're taking Paxlovid. Here's what the FDA monograph on Paxlovid says abour apixaban and Paxlovid together:

Quote

Combined P-gp and strong CYP3A4
inhibitors increase blood levels of
apixaban and increase the risk of
bleeding. Dosing recommendations
for co-administration of apixaban
with PAXLOVID depend on the
apixaban dose. Refer to the
apixaban product label for more
information.
[www.fda.gov] (see page 12)

And the drugs.com interaction checker labels it a major interaction:

Quote

Ritonavir may significantly increase the blood levels of apixaban. This can increase the risk of serious or life-threatening bleeding complications. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
[www.drugs.com]

So definitely make sure your doctor addresses this issue before prescribing it. I'd guess the Eliquis dosage needs to be cut in half while you're taking it.
Re: Paxlovid while on Eliquis
September 25, 2022 03:14AM
Thank you all for the feedback. Since covid has been implicated in clotting issues I would be reluctant to give up my aixaban completely. As Cary suggested I will most likely take half a dose if I wind up taking paxlovid.
Re: Paxlovid while on Eliquis
September 25, 2022 05:16AM
And if you are already on a half dose 2.5mg Eliquis? Quarter the pill?
Re: Paxlovid while on Eliquis
September 25, 2022 06:19PM
I wouldn't be self-dosing with this one. I'd say people need to consult the EP who prescribed their anticoagulant and understands the individual medical issues. Clotting risk, bleeding risk, and kidney and liver function would all be considerations. Way above the pay grade of anyone here.
Re: Paxlovid while on Eliquis
September 26, 2022 03:16AM
Quote
Carey
I wouldn't be self-dosing with this one. I'd say people need to consult the EP who prescribed their anticoagulant and understands the individual medical issues. Clotting risk, bleeding risk, and kidney and liver function would all be considerations. Way above the pay grade of anyone here.

Understood.
I would consult with my PCP and/or EP regarding my apixaban dosage should I elect to take Paxlovid.
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