Eliquis and Hair Loss
Eliquis (apixaban) is not documented to cause hair loss in the available medical literature and guidelines. There is no evidence linking this anticoagulant to alopecia as an adverse effect.
Evidence Assessment
The provided evidence focuses exclusively on medications known to cause hair loss, and apixaban/Eliquis is notably absent from all comprehensive reviews of drug-induced alopecia 1, 2, 3, 4, 5.
Medications Documented to Cause Hair Loss
The literature identifies specific drug classes associated with alopecia:
Retinoids (acitretin): Hair loss occurs in up to 75% of patients, though frank alopecia is observed in <10% of treated patients, with higher rates in women at doses exceeding 17.5 mg daily 6
Antiseizure medications: Valproate, lamotrigine, and carbamazepine are extensively reported causes, with 1,656 documented cases across multiple ASMs 5
Anticoagulants mentioned: While the literature states "all anticoagulant drugs can produce hair loss," this refers primarily to older agents like warfarin and heparin, not direct oral anticoagulants like apixaban 4
Other documented causes: Antithyroid drugs, beta-blockers, oral contraceptives, lithium (15% of patients), chemotherapy agents, and various psychotropic medications 1, 4
Clinical Considerations
If Hair Loss Occurs While Taking Eliquis
Investigate alternative causes: Telogen effluvium may result from fever, severe illness, stress, hemorrhage, or recent childbirth—all of which require thorough exclusion before attributing hair loss to any medication 1
Consider the underlying condition: Patients on anticoagulants may have experienced recent medical stressors (surgery, acute illness, hospitalization) that independently trigger hair shedding 2
Temporal relationship alone is insufficient: A temporal association between starting Eliquis and hair loss does not establish causation, as multiple confounders must be excluded 1
Expected Pattern of Drug-Induced Hair Loss
When medications do cause alopecia, it typically presents as:
- Diffuse, non-scarring pattern that is reversible upon drug withdrawal 3, 4
- Telogen effluvium beginning 1-3 months after medication initiation 7
- Resolution within 3-6 months as the body adjusts, with hair growth occurring at approximately 1 cm/month 7, 8
Recommendation
Do not discontinue Eliquis based on hair loss concerns without consulting the prescribing physician, as the thromboembolic risks of stopping anticoagulation far outweigh cosmetic concerns. Instead, pursue evaluation for other causes of alopecia while continuing anticoagulation therapy.