From the Research
It is not recommended to take donanemab with Eliquis (apixaban) without consulting a healthcare provider due to the potential increased risk of bleeding, particularly cerebral microhemorrhages or ARIA (Amyloid-Related Imaging Abnormalities). Donanemab is a newer Alzheimer's disease treatment that targets amyloid plaques, while Eliquis is an anticoagulant used to prevent blood clots and strokes. The primary concern with this combination is the potential increased risk of bleeding, particularly cerebral microhemorrhages or ARIA, which can occur with anti-amyloid therapies like donanemab 1. Eliquis, being a blood thinner, could theoretically compound this risk.
Some key points to consider:
- Donanemab has been shown to reduce cerebral plaque but not tau load and only marginally improve the primary outcome of cognition and activities of daily living 2.
- The use of apixaban in patients with severe renal impairment has been studied, and it is possibly associated with a lower prevalence of bleeding and thromboembolic events compared with warfarin therapy in patients with end-stage renal disease 3.
- However, there is limited data on the specific interaction between donanemab and Eliquis, and the potential increased risk of bleeding is a concern.
- A recent review of the safety and efficacy of donanemab, lecanemab, aducanumab, melatonin, and aerobic exercise for a short time on cognitive function in mild cognitive impairment and mild Alzheimer's disease found that melatonin may be a better potential disease-modifying treatment for cognitive decline in mild AD and MCI 4.
Your doctor will need to carefully weigh the benefits of donanemab for your Alzheimer's disease against the potential increased bleeding risk if you're already taking Eliquis for a condition like atrial fibrillation or venous thromboembolism. They may recommend additional monitoring, such as more frequent MRI scans, to check for signs of bleeding if both medications are deemed necessary for your treatment.