From the Research
Depakote (valproic acid/divalproex sodium) and Eliquis (apixaban) can generally be taken together, but this combination requires careful monitoring by a healthcare provider due to the potential increased risk of bleeding. The primary concern with this combination is that both medications can affect bleeding risk, albeit through different mechanisms. Depakote is primarily used to treat seizures, bipolar disorder, and migraines, while Eliquis is an anticoagulant that prevents blood clots. According to a study on the pharmacokinetic interactions between direct oral anticoagulants (DOACs) and antiepileptic drugs 1, older antiepileptic drugs can significantly reduce the anticoagulant effect of DOACs, but valproate's interaction with apixaban is not as well-defined. However, another study on valproate-associated coagulopathies in children suggests that valproate can cause coagulation problems, including thrombocytopenia and von Willebrand disease 2.
When taking both medications, it's essential to watch for any unusual bleeding or bruising, as Eliquis already increases bleeding risk, and Depakote may occasionally affect platelet function. Regular blood tests to monitor liver function are crucial with this combination, as Depakote can cause liver issues. Never adjust or stop either medication without consulting your doctor, as sudden discontinuation could lead to serious consequences like seizures (with Depakote) or increased stroke risk (with Eliquis). Always inform all healthcare providers about all medications you're taking to ensure proper coordination of your care. Key points to consider include:
- Monitoring for signs of bleeding or bruising
- Regular liver function tests
- Avoiding sudden discontinuation of either medication
- Informing all healthcare providers about current medications Given the potential risks, careful monitoring and open communication with healthcare providers are vital when taking Depakote and Eliquis together, as supported by studies on the management of direct oral anticoagulants in the perioperative period 3 and the risk of thrombocytopenia during valproic acid therapy 4.