Apixaban/P-gp and Moderate CYP3A4 Inhibitors Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Some medicines may slow down how quickly your body processes apixaban.
What might happen:
The amount of apixaban in your blood may increase, which may increase your risk of bleeding, including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. If you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Eliquis (apixaban) Australian prescribing information. Bristol-Myers Squibb Australia Pty. Ltd. July 21, 2011.
- 2.Eliquis (apixaban) Canadian prescribing information. Bristol-Myers Squibb-Pfizer March 12, 2019.
- 3.Eliquis (apixaban) UK summary of product characterstics. Bristol-Myers Squibb/Pfizer EEIG, Bristol-Myers Squibb House May, 2021.
- 4.Eliquis (apixaban) US prescribing information. Bristol-Myers Squibb Company April, 2021.
- 5.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and- drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
- 6.Hanigan S, Das J, Pogue K, Barnes GD, Dorsch MP. The real world use of combined P-glycoprotein and moderate CYP3A4 inhibitors with rivaroxaban or apixaban increases bleeding..
- 7.Wiggins BS, Dixon DL, Neyens RR, Page RL 2nd, Gluckman TJ. Select Drug-Drug Interactions With Direct Oral Anticoagulants: JACC Review Topic of the Week..
- 8.Pham P, Schmidt S, Lesko L, Lip GYH, Brown JD. Association of Oral Anticoagulants and Verapamil or Diltiazem With Adverse Bleeding Events in Patients With Nonvalvular Atrial Fibrillation and Normal Kidney Function. JAMA Netw Open;3(4)(2574-3805 (Electronic). 2574-3805 (Linking)):.
- 9.Friberg L. Safety of apixaban in combination with dronedarone in patients with atrial fibrillation. Int J Cardiol;264(1874-1754 (Electronic). 0167-5273 (Linking)):.
- 10.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
- 11.Milner E, Ainsworth M, Gleaton M, Bookstaver D. Assessment of Anti-Xa activity in patients receiving concomitant apixaban with strong p-glycoprotein inhibitors and statins. J Clin Pharm Ther 2022 Jan 15.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.