From the Guidelines
Eliquis is not contraindicated in colitis, but its use should be individualized based on the severity of the colitis and the patient's bleeding risk. The provided evidence from the AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis does not specifically address the use of Eliquis in colitis 1. However, it is essential to consider the potential risks and benefits of anticoagulation in patients with colitis, particularly those with active gastrointestinal bleeding.
Key Considerations
- Patients with colitis can generally take Eliquis when it's prescribed for appropriate indications such as atrial fibrillation or venous thromboembolism.
- Caution should be exercised in patients with active gastrointestinal bleeding, which can sometimes occur in severe colitis 1.
- The decision to use Eliquis in a patient with colitis should be individualized based on the severity of the colitis, the patient's bleeding risk, and the indication for anticoagulation.
- Regular monitoring of symptoms and close communication with healthcare providers is essential for patients with colitis who are prescribed Eliquis.
Management of Colitis
The AGA guidelines recommend using biologic agents such as infliximab, adalimumab, golimumab, vedolizumab, tofacitinib, or ustekinumab for the management of moderate to severe ulcerative colitis 1. However, the use of these agents does not directly impact the decision to use Eliquis in patients with colitis.
Bleeding Risk
Patients with colitis who take Eliquis should monitor for signs of increased rectal bleeding or blood in the stool and report these symptoms to their healthcare provider immediately. The risk of bleeding may temporarily outweigh the benefits of anticoagulation in patients with active gastrointestinal bleeding 1.
From the Research
Eliquis Contraindication in Colitis
- There is no direct evidence that Eliquis (apixaban) is contraindicated in colitis 2, 3, 4, 5.
- However, studies suggest that patients with colitis may be at a higher risk of gastrointestinal bleeding when taking oral anticoagulants, including Eliquis 3, 4.
- A study found that apixaban was associated with a lower risk of upper gastrointestinal bleeding compared to other oral anticoagulants, such as rivaroxaban and warfarin 4.
- Another study noted that the risk of gastrointestinal bleeding in patients taking oral anticoagulants, including Eliquis, may be increased in patients with certain underlying conditions, such as colitis 5.
- A review of diagnostic methods and drug therapies for ischemic colitis found that colonoscopy combined with histopathological biopsy is the standard of diagnosis, and most patients respond well to conservative treatment 6.
- There is no specific mention of Eliquis being contraindicated in colitis, but patients with colitis should be closely monitored when taking oral anticoagulants, including Eliquis, due to the potential increased risk of gastrointestinal bleeding 3, 4, 5.