{"componentChunkName":"component---common-build-questions-template-js","path":"/questions-and-answers/can-i-do-cannabis-if-i-m-taking-eliquis-a-blood-thinner","result":{"data":{"question":{"title":"Can I do cannabis if I’m taking Eliquis, a blood thinner? ","slug":"can-i-do-cannabis-if-i-m-taking-eliquis-a-blood-thinner","createdAt":"October 8, 2020","image":null,"tags":[{"id":5052,"name":"Cannabis","slug":"cannabis"},{"id":5118,"name":"Circulation","slug":"circulation"}],"childMarkdownRemark":{"excerpt":"yes ,, but make sure your INR is ck 1x a week GMAN The cytochrome p450 system accounts for 70 to 80 percent of the…","html":"
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yes ,, but make sure your INR is ck 1x a week

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GMAN

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The cytochrome p450 system accounts for 70 to 80 percent of the enzymes involved in drug clearance, making it the most important system for drug metabolism. Both THC and CBD are competitive inhibitors of three different enzymes in the cytochrome p450 system, two of which are involved in the metabolism of Eliquis (apixaban). This means that CBD and THC are competing for the same receptors as is Eliquis. So when Eliquis is taken concurrently with CBD and/or THC, Eliquis levels could possibly rise. When Eliquis levels rise excessively, blood clotting may be compromised leading to signs ranging from frequent bloody noses all the way on up to a potentially fatal event, such as a hemorrhagic stroke or heart attack.\nhttps://ghr.nlm.nih.gov/primer/genefamily/cytochromep450

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Another case report suggested that extremely high doses of CBD can lead to markedly elevated coumadin (Warfarin) levels. Coumadin is a blood thinnner that is metabolized similarly to how Eliquis is. Enrolled in a clinical trial evaluating CBD as a potential treatment for epilepsy, the test subject was given extremely high doses of CBD. He was first given doses averaging 265mg, which resulted in slightly elevated coumadin levels. At doses averaging 528mg, the coumadin levels were markedly elevated. After reducing the coumadin dose, INR results normalized. Relevantly, very few patients, if any, would ever take as much CBD.\nhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789126/

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drkim

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However, like coumadin, a highly elevated Eliquis level can lead to serious consequences. Accordingly, you should discuss the matter with your prescribing physician and also monitor your INR results with additional vigilance.

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drkim

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Dr. Kim points out the potential danger of taking cannabis with medications that compete for the same metabolic pathway. Fortunately, as a practical matter there is little in the medical literature describing any actual clinical cases of excess anticoagulation based on cannabis use while on Coumadin etc. In fact, I often speak with patients who have been using cannabis while on anticoagualant medications and none of them has ever reported a clinically significant effect requiring reduction of anticoagulant dose. I do not consider being on anticoagulant medication a contraindication to cannabis use. I'd say cannabis users on anticoagulant medication should be careful to have regular INRs to keep an eye on the situation, and would expect to see little change unless other medications are involved or very large amounts of cannabis are being used.

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drelkind

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Hi!

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While I couldn't find info about Eliquis, this article is pretty extensive and covers the topic of cannabis and how it affects blood pressure. I'm no medical professional, but it looks like the studies produced mixed results.

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There's also bunch of handy general info on blood pressure medications side effects, as well as blood pressure readings. Definitely worth a read!

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https://www.hellomd.com/health-wellness/5c4901f99cbdac000854fc82/can-cannabis-help-lower-blood-pressure

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atkanesh

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