From the Research
A hypercoagulable workup should not be performed while a patient is on Eliquis (apixaban) as it will interfere with the accuracy of many coagulation tests, potentially leading to false positives or false negatives, as demonstrated by a study published in 2019 1. Eliquis is a direct oral anticoagulant (DOAC) that inhibits factor Xa and affects multiple clotting parameters. For accurate testing, Eliquis should be discontinued for at least 48 hours before collecting blood samples for a hypercoagulable workup. Some specific tests that are affected include:
- Protein C and S activity
- Antithrombin activity
- Activated protein C resistance
- Lupus anticoagulant testing
- Clot-based factor assays Certain genetic tests like Factor V Leiden mutation or prothrombin gene mutation can still be performed while on Eliquis since they analyze DNA rather than clotting function. If a hypercoagulable workup is necessary, coordinate with the prescribing physician about temporarily stopping Eliquis, considering the patient's thrombotic risk during this period, as supported by a study published in 2016 2. In urgent situations where anticoagulation cannot be safely interrupted, this limitation should be clearly documented when interpreting test results, as highlighted in a study published in 2021 3 and another in 2016 4. It is essential to prioritize the patient's thrombotic risk and consider the potential consequences of inaccurate test results, as emphasized in a study published in 2005 5.