Should I stop taking Eliquis (apixaban) and go to the emergency department for severe left groin and testicular pain that started after beginning the medication for my DVT?

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Last updated: November 8, 2026 • View editorial policy

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Seek Emergency Evaluation Immediately—Do Not Stop Eliquis Without Medical Supervision

You should go to the emergency department now for urgent evaluation of your severe left groin and testicular pain, but continue taking Eliquis until a physician evaluates you and provides alternative anticoagulation if needed. Stopping anticoagulation abruptly significantly increases your risk of recurrent DVT, pulmonary embolism, and stroke 1.

Why This Is Urgent

Severe groin and testicular pain that exceeds your DVT pain requires immediate evaluation for several potentially serious conditions:

  • DVT extension into iliac or pelvic veins causing venous congestion and testicular pain
  • Retroperitoneal bleeding (a known complication of anticoagulation) that can compress the ureter and refer pain to the testicle 2
  • Testicular torsion, epididymitis, or other urological emergencies unrelated to anticoagulation
  • Inguinal or femoral vein thrombosis with secondary testicular involvement

The FDA label for Eliquis explicitly warns about "unexpected pain, swelling, or joint pain" as potential signs of serious bleeding 1. While testicular pain is not specifically listed, severe pain in the groin region warrants urgent assessment for bleeding complications.

Critical Management Points

Do NOT Stop Eliquis on Your Own

  • Premature discontinuation of Eliquis dramatically increases thrombotic risk 1
  • The CHEST guidelines emphasize that stopping anticoagulation requires "adequate alternative anticoagulation" 3
  • If Eliquis must be stopped, you need bridging therapy or alternative anticoagulation immediately

What the Emergency Department Will Do

The ED physicians will:

  1. Perform urgent imaging (likely CT with contrast) to evaluate for:

    • Retroperitoneal hematoma
    • DVT extension
    • Testicular pathology
    • Bleeding complications

  2. Assess bleeding risk versus thrombotic risk:

    • If significant bleeding is found, they may temporarily hold Eliquis and consider reversal agents
    • If no bleeding is identified, they will likely continue anticoagulation while treating the underlying cause

  3. Provide alternative anticoagulation if needed:

    • LMWH (low molecular weight heparin) can be used if Eliquis must be stopped 3
    • This maintains DVT treatment while allowing more rapid reversibility if intervention is needed

Common Pitfall to Avoid

The most dangerous mistake would be stopping Eliquis without medical supervision. Your DVT requires at least 3 months of anticoagulation 3. Stopping treatment prematurely—even for severe pain—could result in:

  • Fatal pulmonary embolism
  • DVT extension
  • Post-thrombotic syndrome
  • Stroke (if you have atrial fibrillation)

What to Tell the ED

Clearly state:

  • "I started Eliquis [X days/weeks] ago for DVT"
  • "My groin/testicular pain is worse than my original DVT pain"
  • "I have not stopped taking Eliquis"
  • Bring your medication list and the name of the physician who prescribed Eliquis

The ED team needs this information to coordinate your care and ensure anticoagulation continuity if Eliquis must be modified.

Bottom Line

Go to the emergency department immediately while continuing your Eliquis. Severe pain that exceeds your DVT symptoms requires urgent evaluation for potentially life-threatening complications. Only emergency physicians with imaging and laboratory results can safely determine whether to continue, modify, or temporarily hold your anticoagulation. Do not make this decision independently—the risk of stopping anticoagulation without proper medical management far outweighs the inconvenience of an ED visit.

References

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.