Tumeric and Apixaban

Tumeric and Apixaban – Guest Post by Amanuel Tseggai
A 72 year old man was newly diagnosed with atrial fibrillation and started on therapeutic dose of Enoxaparin after he was admitted to a hospital.  Four days into his treatment with Enoxaparin his primary care provider decided to switch him to Apixaban- one of the newer oral anticoagulants.
During the formal counseling on his regimen patient’s wife pointed out that he takes an herbal product called Turmeric for his chronic inflammatory condition. Her main concern was whether or not concurrent use of this herbal product and Apixaban will cause adverse effect(s).
After some research by pharmacy it was learned that Turmeric contains an an ingredient – Curcumin, which is believed to slow down blood clotting. As such, taking Turmeric along with medications that also slow clotting might increase the chances of bruising and bleeding (WebMD).
Action: After consultation with the primary care provider, the patient was advised to stop taking this herbal product while on Apixaban therapy.
The take home message for pharmacists who participate in anticoagulation management and counseling is that we should thoroughly review patient’s home medications, including herbal products and identify and address the ones that can impact  our physiological hemostasis one way or the other.
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31 Comments

  1. Nahed

    Very interesting case. Thank you so much

    Reply
  2. Joop Klinkhamer

    Seems more logical to lessen the dose of apixaban!

    Reply
    • Ken Parnaby

      Not someone thinking properly again – I can’t find blood thinning number, for 5mg Apixaban or 3gm of turmeric, to enable a proper calculation – anybody out there help, please. I like turmeric!!

      Reply
      • Mark Liverett

        Hi Ken,

        I like many have questions about Turmeric. I’m taking 2.5 Eliquis x 2 per day, and 1000 mg Turmeric per day as well for over 6 months. I also take a few peppercorns to help absorb. I’ve had numerous DVT’s in my calves and one PE 6 years ago. To date I have had zero interactions of any kind. No bleeding that I could identify with. I would take a small doses of turmeric and work your way up and monitor results.

        Turmeric is a great supplement, it has so many applications. I have many allergies, turmeric keeps them at bay very well. Note; I have very thick blood, I have never had any of the normal side effects on Eliquis.

        Reply
        • candy

          Turmeric (since it’s not regulated) has no set amount of blood thinning ability, and i’m sure each company’s is different. I would t trust it to thin the blood at a regulated number.

          Reply
  3. Angela Myrie

    Need info on

    Reply
  4. Harrissa

    Dosage of tumeric varies.
    If no bruising occurs, one must weigh up pros and cons.
    So far my 90 year old mother whose behaviour suggested onset of alzheimers…. she has gained a new lease of life with greater mobility better morale, less depression and improved cognitive ability thanks to extra strong
    tumeric, daily as well as ashwagandha, DHEA, COq10, OMEGA 3, probiotics, chrondroitin glucosamate MSM, zinc-
    magnesium vit D and cordiceps/reichi ….

    Reply
    • charles bradley

      I have been taking turmeric for prostate cancer and my psa blood tests show it has reduced 3 times over 12 months , but 1 have had a bladder infection the examination shows blood spots in urine allso two sore spot in my bladder i hope they arnt connected. chas.

      Reply
  5. Vicky

    Then if Curcurmin from the Turmeric plant does the same job at thinning the blood why would GP’s prescribe a risky chemical such as Apixaban? Why not take a much higher dose of Turmeric and other blood thinning herbs so that your body naturally keeps clots from forming? If the govt. did proper research on this we would be a much healthier country. Instead they bow to the chemical companies and do not put us first. Curcumin supplements lower the risk of cancers developing but if the right clinical trials are not carried out it cannot be taken forward.

    Reply
    • Michel Georges Olivier

      to Vicky,
      I fully understand your frustration concerning the pharmaceutical companies,. At the price of Eliquis my wife would love to switch to Curcumin, however after a short trial and stomach upsets she had to give it up. My sun tried it also and had the same problems.

      Reply
    • Celine Dan

      I agree with Vicky!!
      I’m on Eliquis and wish I could just take the “plunge” and get off of it.
      And start taking all those natural blood thinning foods like turmuric, garlic, omega 3, etc.
      But once in the “system” of medication, one is too leary of going off of it .
      There has to be, and likely in future when I’m off this planet……….researches , and medications made totally from these natural foods and herbs.

      Reply
  6. Trevor Irwin

    I am on eliquis too after getting A-Fib. I have very low cholesterol and no sign of cardiovascular disease but had high heart rate and had a cardioversion. Now being maintained on Sotalol and Apixiban but even though I’d love to use natural blood thinners I don’t know how effective they are compared to Apixaban: how reliable is the research?

    Reply
  7. Monique Vanhuizen

    Hi guys
    I also use apixaban and have been on Turmeric for as long as apixa. I have no problems and will continue as it helps with inflation. I too would love to come off all these chemical but to scared.

    Reply
    • Lynne langmaid

      How much tumeric you take. How much eliquis

      Reply
    • Paula Lechten

      I take 2000mg curcumin daily for iron overload. I also take 5 mg eliquis 2x daily for afib. I make sure I do not take them together. I have had no problems with bruising. I have been taking them for 5 months.

      Reply
  8. Lynne langmaid

    Soyou take curcumin nit full Tumeric?

    Reply
  9. Amanuel Tseggai, PharmD, BCPS

    What we are trying to highlight by bringing this case report is that people need to be cognizant of the fact that this (Tumeric) and many other herbal products ,that undoubtedly have health benefits, also cary some risks especially when mixed with potent anticoagulants like Apixaban. That’s because they contain an ingredient which possesses blood thinning property. One person entertained the idea of using Tumeric as a substitute to Eliquis. The problem with that is that this herbal product hasn’t been clinically studied for that purpose and to what extent it can exert anticoagulant property.
    What is important to understand is that certain herbal products contain ingredients that can cause blood thinning and should either be avoided (ie. if being experimented as a prophylaxis) or used with caution (i.e inflammation, iron overload) when placed on anticoagulation therapy.

    Reply
    • Elaine Babor

      I was just diagnosed with aFib and have been taking 1000 mg turmeric per day for inflammation. The turmeric works great for my osteoarthritis, better than Celebrex. Now with beginning blood thinner my doc says to eliminate turmeric but has no solution to deal with my inflammation. This is a problem. Research is desperately needed. Don’t know what to do!

      Reply
    • Jean

      Perhaps you should consider ‘How Apixaban works’. It works by reducing the blood plasma proteins, Albumins ,Globulins, and Fibrinogen. Most of these proteins are found in food. Research them. They are needed by the body to repair and maintain our enzymes and cells. I developed AF (high heart rate). My clotting levels and all tests were spot on. I was prescribed 20mg of Rivaroxaban a day later changed to Eliquis 2.5mg twice a day. Nobody knows the cause of AF and yet they prescribed dangerous drugs which deplete the immune system. When other illnesses appear, they are often treated with another drug. Usually a pain killer to relieve the pain in the legs and back caused by the drug destroying the supporting muscle tissues. Showing leg pain as a side effects. Of course we all know the pharmaceuticals are self serving, they will always have another immune damaging drug to cure any side effects. We are not given the true facts which are difficult to obtain, in order that we can make our own decision. I immediately produce inflammation when I ingest synthetic chemicals, in anything, I’m sure I’m not unique. I’ve used Curcumin many times for very advanced inflammation when drugs made it worse. At this moment I’m taking 2.5 mg Eliquis AM and Curcumin (Turmeric) PM. Keeping my fingers crossed. At least the curcumin will address some of the areas that Apixaban causes.

      Reply
  10. Matthew B Zimmerman, Pharm.D.,MHA,CMTM

    Thanks for the astute insight! This example emphasizes the need for comprehensive medication therapy management for patients. A comprehensive review always includes a review of OTC medications, as well as foods, herbal supplements and anything chemically ingested or used by patients. Also what is the genetic make-up of patients that may influence patient health outcomes. In addition, although one patient may be fine with a combination of whatever, that does not mean the next patient will not react adversely. Thorough patient counseling and monitoring patient response is vital! Know your patients well!!!

    Reply
    • Gaye Carman

      Mathew, it would appear that most dr’s do not worries about the genetic makeup of their patients, all they seem to know about is drugs and one size fits all.
      I was a 75 (look 65) healthy woman and I had never been on drugs before, but my heart went into Afib and because the drugs didn’t work, I was given an ablation in July, which was a fantastic success. It instantly stopped any Afib, and of course I was sensibly put on a course of drugs, three different lots, twice a day.
      Consequently I now have to take masses of doses of, plus fluid tablets to take away the water that the heart tablets have now caused, but fluid tablets cause a lack of potassium unless it already has potassium in it which mine didnt.
      I am now in a bad way from these heart drugs and my specialist will not see me till February which at that stage was 4 months away.

      Since I had the ablation and went on these tablets, I have put on 8 kgs which is not good for my heart, I am too extremely tired to do anything let alone go for a walk and I now get puffed quickly, perhaps because of the massive accumulation of fluid around my once flat abdomen making me look like 7 months pregnant, my feet now looks like footballs. I was constantly thinking of dying, (not suicidal) so I took the risk and cut the tablets back to once a day, but still have to take masses of laxatives, still have fluid retention, my arms and shoulders still hurt like mad so can’t sleep well, and there is a lot more that I have.

      I have read about the side effects of all these drugs and it means that, ok they might stop my heart from going into AFib again, but now the long term effects mean that I am more than likely will get kidney, lung, and liver problems, plus the possibility of dementia or Alzheimer’s, thus I will then be put on more drugs to help these situations.
      So one has to decide which is more important to them, taking natural products and the maybe risks of going off the drugs and hopefully living a healthy life on natural medicines, or maybe living a bit longer with a carton full of drugs to keep them alive unhealthily. It is a hard one as we all want to cling to life like mad…

      Reply
      • Denise H Thomas

        Dear Gaye, I can relate to your story for I too suffered from Afib in 2018, shortly after being diagnosed I had a heart attack. A stent was put in place and a few months later I underwent an ablation which got rid of the Afib. And yes I was put on so much medication that I was living in a fog. Medication were changed and finally I am on eliquis 2.5mg twice a day, I was also on Atorvarstatin for cholesterol control. I am working at moving away from pharmaceutical drugs. I have decreased the statin from 80 mg to 20 mg a day and the last blood test showed normal HDL level. I then eliminated the 20 mg because of cramps since last month and I’ll see what the numbers are on the next visit. I must say that along with switching with natural herbs I have changed my food intake. I have learned that we do not need to eat as much food as we eat volume wise so no seconds. I have cut as much of the saturated fat as I can, I eat nuts for snacks. I am looking into the turmeric supplements as I am reading a lot of good reports about it. Perhaps I will cut the Eliquis to one pill a day and take a turmeric supplement. Yes, I am nervous about telling my doctors about my changes for they most likely will scare me literally to death. Well here is my take on the whole situation. I do not know when the Lord will take me home, I know that I cannot change the date, it is in His hands. What I want to do however is to live whatever time I have in a relatively fair health so that I can function throughout the day, not be a burden to anyone, and even be able to do some good for those around me. Doctors have their hands full with patients who for the most part do not want to alter their diet or change their life style and so they put bandages on the symptoms and the drug industry is laughing all the way to the bank. (so to speak) Hope this helps.

        Reply
  11. James Allan

    My pacemaker just showed an incident of afib. My cardo doc just prescribed me apixaban. I cut the 5mg pill in half for my first dose because I was smart enough to look up the “Side Effects” first and “Drug Interactions”. I didn’t find out about Tumerics blood thinning effect until after I took the apixaban. I took the half pill of apixaban and I felt like pure chit. I was going to go out and run errands but had to lay down for 2 hours my head and body felt so bad. I was lucky it did pass. I decided not to take the apixaban anymore or at least for a while until I research it better.

    I had started taking 1500mg a day of Tumeric a couple months before because I was getting PVC’s and heart palps. The Tumeric stopped the PVC’s and heart palps. After I realized Tumeric was a blood thinner also I increased my dosage to 2000mg a day and I feel much better. Then I went out and purchased the “Qunol” brand of Tumeric that had ultra high absorption and felt even better with no heart palps.

    I don’t like bucking doc like this with my own prescription choice but hey, if I don’t have to put up with all those side effects of feeling like chit I will. I will do my best not to have to deal with those side effects of apixaban if all possible. If Turmeric and aspirin will thin my blood enough that’s the way it will be. There’s a clotting test anyone can do. Yank a hang nail out and see how long it takes for the bleeding to stop. If you bleed for a long time your blood is thin enough. I remember when I was in the hospital the nurse pulled out two of my IV lines, put the bandage on and 10 minutes later I had streams of blood on both of my arms ending up in the palms of my hands. I flagged down another nurse and she tightened up the bandages.

    Reply
    • Eric Christianson

      I would recommend discussing this with your doctor and/or pharmacist. Thanks for the comment!

      Reply
    • Elaine Babor

      I was diagnosed with aFib last year while taking turmeric, garlic, aspirin and omega 3. My cardiologist started me on Eliquis and took me off all my wonderful natural blood thinners. I objected but he told me that the herb companies don’t have the funds to run their testing like big pharma does so there is no way to compare the results of natural vs man made chemical drugs. I begrudgingly am taking Eliquis and metroprolol. Wish there was funding available for natural solutions

      Reply
  12. Billy M.

    I had been on high daily dose of a quality tumeric and also garlic.I still fell victim to a blood clot that ran from my ankle to my groin.After being soley on Xarelto for q year now I have full flow of blood but still traces of of the clot in my vein.So tumeric and garlic didn’t prevent an extensive clot from forming in my leg ! I either die from a blood clot or from inflammation.Ashes to ashes, dust to dust, if old age don’t get you, something must or danged if you do and danged if you don’t.

    Reply
  13. brian

    What are the possible dangers of taking 200mg TURMERIC once daily and APIXABAN 5mg twice daily.

    Reply
    • Theo Fishwick

      I have been taking Apixaban for A-Fib for 12 months and recently developed severe arthritis. I cannot take NASAIDS such as Voltaren, and codeine doesnt help much. However turmeric gives me serious relief from arthritis, so I’ve switched to taking Tumeric caps (1/day)
      containing 325mg of cucurmin and have halved my dose of Apixaban. So far so good.

      Reply
  14. Sarah j marvin

    Has anyone actually had a negative reaction or event from taking 2.5mg apixaban twice per day and any amount of curcumin or garlic, other than a nose bleed?

    Reply
  15. Mr. Angel Esteban

    Comment
    I am 72 years old (73 in 2 month’s time). Just before heading back to Philippines, I had another ECG where A-Fib was discovered. I was put on 5mg of Eliquis twice daily. Pharmaceutical cost in Australia for Senior (retired) is only A$5.50 per prescription. I ran out of my stocks while in the Philippines (dual citizen) but my Australian doctor refused to prescribed Eliquis because I am overseas. The dosage of Eliquis in the Philippines will cost me roughly A$150 instead of my usual A$5.5. As an old age pensioner, I can not afford to continue using Eliquis. I asked my son to contact my doctor as to my option, he suggested taking PARACETAMOL (which I reckon, he meant ASPIRIN) while overseas, which might take another year because Australia border won’t reopen not until mid to end or 2022. For the meantime, I searched for alternative – that’s how I found TURMERICAP plus, which I started taking day after I ran out of Eliquis. I don’t have any adverse effect, in fact my hand arthritis for many years was remedied in addition to the blood thinning characteristic of Turmeric. My heart beat remains stable (below 80). A friend who is a Nurse insisted that I resume with Eliquis and stop Turmeric, unless I get permission from my doctor, which I doubt will agree since Pharmaceutical companies have control over these medical practitioners. That’s how powerful these companies in securing their business. I requested my son in Australia to get my doctor of over 30 years about his opinion. Turmericap plus cost me only A$16 per month instead of A$150 per month of Eliquis in the Philippines. No wonder many Filipinos would rather die than buy excessively expensive medicines compared to their income (up to 50% of their gross salary just for one prescription).

    Reply

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Written By Eric Christianson

December 28, 2016

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