Apixaban interactions

Full monograph for Apixaban Check it against another medicine

Medicines

233 documented

Severity

Mechanism

Medicines documented to interact with Apixaban, worst severity first.
Medicine	Severity	Mechanism	Effect	Sources
Acalabrutinib	Major	Synergy	Coadministration of acalabrutinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications.	3 sources — open the full entry
Allium cepa + Heparin + Allantoin	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Alteplase	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Apalutamide	Major	Metabolism	Coadministration with potent inducers of CYP450 3A4 that also induce P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of apixaban…	8 sources — open the full entry
Aspirin	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Aspirin + Dipyridamole	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…2 documented mechanisms	39 sources — open the full entry
Betrixaban	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Bivalirudin	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Bromfenac Sodium	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Cabozantinib	Major	Synergy	Coadministration of cabozantinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment…	39 sources — open the full entry
Carbamazepine	Major	Metabolism	Coadministration with potent inducers of CYP450 3A4 that also induce P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of apixaban…	8 sources — open the full entry
Cilostazol	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Clopidogrel + Aspirin	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…2 documented mechanisms	39 sources — open the full entry
Clopidogrel Bisulphate	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Dabigatran Etexilate Mesylate	Major	Synergy	Drugs that can affect hemostasis such as glycoprotein IIb/IIIa inhibitors, thienopyridine antiplatelet agents, unfractionated and low molecular weight…	3 sources — open the full entry
Dalteparin Sodium	Major	Synergy	Drugs that can affect hemostasis such as dextran, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or other anticoagulants may potentiate the…	7 sources — open the full entry
Dasatinib	Major	Synergy	Coadministration of dasatinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment with…	5 sources — open the full entry
Deferasirox	Major	Synergy	Coadministration with drugs that have known ulcerogenic or hemorrhagic potential may increase the risk of gastrointestinal bleeding associated with the use of…	3 sources — open the full entry
Dexibuprofen	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Dexketoprofen	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Dextran + Hypromellose	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Diclofenac Diethylamine + Mephenesin + Menthol + Methyl Salicylate + Turpentine Oil	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Diclofenac Potassium	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Diclofenac Sodium	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Diclofenac Sodium + Lidocaine Hydrochloride	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Diclofenac Sodium + Methyl Salicylate + Linseed Oil + Menthol	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Diclofenac Sodium + Misoprostol	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Dipyridamole	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Enoxaparin Sodium	Major	Synergy	Drugs that can affect hemostasis such as dextran, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or other anticoagulants may potentiate the…	7 sources — open the full entry
Enzalutamide	Major	Metabolism	Coadministration with enzalutamide may decrease the plasma concentrations of apixaban. The proposed mechanism is enzalutamide-mediated induction of CYP450 3A4…	7 sources — open the full entry
Eptifibatide	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Etodolac	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Flurbiprofen	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Fondaparinux Sodium	Major	Synergy	Drugs that can affect hemostasis such as dextran, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or other anticoagulants may potentiate the…	7 sources — open the full entry
Fosphenytoin Sodium	Major	Metabolism	Coadministration with potent inducers of CYP450 3A4 that also induce P-glycoprotein (P-gp) may significantly decrease the plasma concentrations of apixaban…	8 sources — open the full entry
Heparin Sodium	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Ibrutinib	Major	Synergy	Coadministration of ibrutinib and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications.	6 sources — open the full entry
IbuprofenOral Topical	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Ibuprofen + Paracetamol	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
IndomethacinOral Rectal	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Itraconazole	Major	Absorption · Metabolism	Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of…	6 sources — open the full entry
Ketoconazole	Major	Absorption · Metabolism	Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of…	6 sources — open the full entry
Ketoconazole + Zinc Pyrithione + Aleovera	Major	Absorption · Metabolism	Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of…	6 sources — open the full entry
Ketoprofenbase Topical	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Ketorolac Tromethamine	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Lopinavir + Ritonavir	Major	Absorption · Metabolism	Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of…	6 sources — open the full entry
Mefenamic acid	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Meloxicam	Major	Synergy	Concomitant use of apixaban with other agents that alter hemostasis such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), platelet aggregation…	39 sources — open the full entry
Mifepristone	Major	Synergy	Concomitant use of anticoagulants may exacerbate mifepristone-induced vaginal bleeding in women. Prolonged, potentially heavy bleeding lasting approximately 9…	4 sources — open the full entry
Mifepristone + Misoprostol	Major	Synergy	Concomitant use of anticoagulants may exacerbate mifepristone-induced vaginal bleeding in women. Prolonged, potentially heavy bleeding lasting approximately 9…	4 sources — open the full entry

Conditions

Conditions in which Apixaban needs care, as documented in this source.

Hemorrhage
Major
The use of factor Xa inhibitors is contraindicated in patients with active pathological bleeding as these agents increase the risk of bleeding and can cause serious or fatal hemorrhages. Caution is recommended when prescribing factor Xa inhibitors to patients at increased risk of bleeding, including patients undergoing procedures where bleeding may cause serious complications. Such patients include those undergoing spinal/epidural anesthesia or spinal puncture; these patients are at high risk of an epidural or spinal hematoma, which can result in long-term or permanent paralysis. In general, when using factor Xa inhibitors, the risk of thrombotic events should be weighed against the risk of bleeding.
4 sources
1. "Product Information. Xarelto (rivaroxaban)." Janssen Pharmaceuticals (2022):
2. "Product Information. Arixtra (fondaparinux)." Mylan Institutional LLC (2020):
3. "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb (2021):
4. "Product Information. Savaysa (edoxaban)." Daiichi Sankyo, Inc. (2021):
Antiphospholipid Syndrome
Moderate
Direct acting oral anticoagulants including factor Xa inhibitors and some thrombin inhibitors as dabigatran, are not recommended for use in patients with antiphospholipid syndrome (APS). Treatment with these drugs has been associated with increased rates of recurrent thrombotic events, especially in patients with triple positive APS.
4 sources
1. "Product Information. Pradaxa (dabigatran)." Boehringer-Ingelheim (2010):
2. "Product Information. Xarelto (rivaroxaban)." Janssen Pharmaceuticals (2022):
3. "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb (2021):
4. "Product Information. Savaysa (edoxaban)." Daiichi Sankyo, Inc. (2021):
Heart Valve Diseases
Moderate
The use of some factor Xa inhibitors (including apixaban, edoxaban, and rivaroxaban) is not recommended in patients with prosthetic heart valves; safety and efficacy have not been established in such patients.
3 sources
1. "Product Information. Xarelto (rivaroxaban)." Janssen Pharmaceuticals (2022):
2. "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb (2021):
3. "Product Information. Savaysa (edoxaban)." Daiichi Sankyo, Inc. (2021):
Hepatic Insufficiency
Moderate
The use of factor Xa inhibitors (including apixaban and edoxaban) is not recommended in patients with moderate or severe liver dysfunction (Child-Pugh B or C) as these patients may have intrinsic coagulation abnormalities.
2 sources
1. "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb (2021):
2. "Product Information. Savaysa (edoxaban)." Daiichi Sankyo, Inc. (2021):

Medicines

Conditions

Hemorrhage

Antiphospholipid Syndrome

Heart Valve Diseases

Hepatic Insufficiency