Can Eliquis (apixaban) cause vision changes?

From the Guidelines

Eliquis (apixaban) can potentially cause vision changes, although this is not a commonly reported side effect. The provided evidence does not directly address the issue of vision changes associated with Eliquis 1. However, considering the mechanism of action of apixaban as a Factor Xa inhibitor and its effects on blood clotting, it is plausible that vision changes could occur due to small bleeding events affecting the eyes or alterations in blood flow to ocular tissues. Some key points to consider when evaluating the potential for vision changes with Eliquis include:

• The lack of direct evidence linking apixaban to vision changes in the provided studies 1
• The importance of monitoring for any changes in vision while taking Eliquis, as this could indicate a serious reaction requiring medical attention
• The need to continue taking the prescribed dose of Eliquis unless directed otherwise by a doctor, to avoid increasing the risk of blood clots, stroke, or other serious complications
• The fact that apixaban has been shown to be effective in reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, with a favorable safety profile compared to warfarin 1 It is essential for patients taking Eliquis to be aware of the potential for vision changes and to seek medical attention immediately if they experience any changes in their vision.

From the FDA Drug Label

Eye disorders: conjunctival hemorrhage, retinal hemorrhage, eye hemorrhage The FDA drug label mentions that eye disorders such as conjunctival hemorrhage, retinal hemorrhage, and eye hemorrhage have been reported in patients taking apixaban 2.

• Vision changes are not directly mentioned in the label, but eye hemorrhage could potentially cause vision changes. However, the label does not provide direct information on whether apixaban can cause vision changes. Therefore, based on the available information, it is unclear whether apixaban can cause vision changes.

From the Research

Eliquis and Vision Changes

• There is no direct evidence in the provided studies that suggests Eliquis (apixaban) can cause vision changes 3, 4, 5, 6, 7.
• The studies primarily focus on the effectiveness and safety of apixaban in preventing thromboembolic events in patients with atrial fibrillation, venous thromboembolism, and renal impairment.
• None of the studies mention vision changes as a potential side effect of apixaban.

Safety and Effectiveness of Apixaban

• Apixaban has been shown to be effective in preventing recurrent venous thromboembolism in patients with active cancer 3.
• The medication has also been found to be safer than warfarin in patients with atrial fibrillation and renal failure, with a lower risk of major bleeding 4.
• A meta-analysis found that apixaban had a lower risk of bleeding compared to conventional anticoagulants in patients with mild renal impairment 5.
• However, the optimal dosing of apixaban in patients with severe chronic kidney disease is still unclear, with some studies suggesting that a lower dose may be associated with a lower risk of bleeding 6.

Apixaban in Patients with Renal Dysfunction

• A retrospective chart review found that apixaban may be a reasonable alternative to warfarin in patients with severe renal dysfunction, with a lower risk of thrombotic and bleeding events 7.
• However, more research is needed to fully understand the safety and effectiveness of apixaban in this patient population.