From the Research
It is safe to resume Eliquis (apixaban) after hematuria due to a renal stone once the bleeding has completely resolved and the stone has passed or been removed, typically 24-48 hours after complete resolution of visible blood in the urine, as supported by the most recent study 1. When considering resuming Eliquis, several factors should be taken into account, including the patient's thrombotic risk and bleeding risk.
- The patient's kidney function should be assessed before restarting Eliquis, as impaired renal function can increase apixaban levels and bleeding risk, as noted in a study on apixaban in patients with severe renal impairment 2.
- The standard dosing of Eliquis should be resumed, typically 5mg twice daily, or 2.5mg twice daily for those meeting dose-reduction criteria.
- A study comparing apixaban to warfarin in patients with end-stage kidney disease found that apixaban was associated with a lower risk of major bleeding and recurrent VTE 3.
- Another study on the effectiveness and safety of apixaban versus warfarin in venous thromboembolism patients with chronic kidney disease also found apixaban to have a lower risk of recurrent VTE and major bleeding 4. However, it is essential to consult with a healthcare provider before restarting Eliquis, as they can provide guidance specific to the patient's medical situation and may want to confirm stone passage with imaging before resuming anticoagulation. The healthcare provider should also be aware of the potential increased risk of bleeding with apixaban administration in patients with acute kidney injury, as reported in a recent study 1. Ultimately, the decision to resume Eliquis should be individualized based on the patient's specific situation, considering both their thrombotic risk and bleeding risk.