Ask the Expert: Common Questions About Alcohol and Blood Thinners

What are blood thins?

Blood thinning medications such as apixaban (Xarelto) or atazanavir (Remicade), which prevent the growth of new blood vessels, may cause some side effects when used with alcohol. These drugs work by blocking certain enzymes involved in making platelets. When these clotting factors enter your bloodstream they block the flow of red blood cells, thus reducing their ability to carry oxygen throughout your body. The effects of alcohol on the body depend on many things including how much you drink, what kind of alcohol you drink, and other factors.

How do blood thinners affect me?

The most common side effect from taking apixaban (Xarelto) or atazanavir (Remicade) is an increase in stomach pain. If you already have liver disease, this could lead to jaundice (yellowing of the skin and eyes). Other possible side effects include nausea, vomiting, diarrhea, constipation, fatigue and dizziness. Some people may experience lightheadedness or fainting spells. Your doctor will monitor you closely if you develop any of these symptoms.

Are there other ways to reduce my risk of getting blood clots?

You can reduce your risk of getting blood clots by following your medical team’s recommendations and avoiding known risks such as smoking. If you need to be immobile for a long period of time, such as when you have a major operation, tell your doctor. In some cases an alternative medication may be used to prevent the formation of blood clots.

What should I know about drinking alcohol with blood thinners?

If you are taking apixaban (Xarelto), avoid drinking large amounts of alcohol. The side effects of this medication can increase the more you drink alcohol. This includes possible bleeding and bruising easily. Limit yourself to one drink a day. If you take atazanavir (Remicade) or rivaroxaban (Xarelto), drinking any amount of alcohol may increase your risk of internal bleeding. Talk to your doctor about how alcohol interacts with your particular medication and what you should do, if anything, while taking this medication.

Can I drink a little bit of alcohol?

If you are taking apixaban (Xarelto), drinking a small amount of alcohol is okay. One drink a day is considered a safe amount. You should try to avoid drinking more than this within any 24-hour period.

Sources & references used in this article:

Anticoagulants and blood thinners during cutaneous surgery: always, sometimes or never by CF Schanbacher – Skin Therapy Lett, 2004 –

The treatment of drinking problems: A guide for the helping professions by G Edwards, EJ Marshall, CCH Cook – 2003 –

Grand Rounds Panel Discussion: Blood Thinners Peri-Operatively: What to do? by MD Jad Al Danaf, A Govind, L Ragupathi, S Wang –

Alcoholism and other drug problems by JE Royce, D Scratchley – 1996 –

Controls on the physical availability of alcohol by T Stockwell, PJ Gruenewald – … prevention of alcohol problems, 2004 –

Alcohol use among older adults by KH Sorocco, SW Ferrell – The Journal of general psychology, 2006 – Taylor & Francis

Cigarettes, alcohol, coffee and peptic ulcer by R Hiscott – Neurology Now, 2016 – LWW