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Apixaban Disease Interactions

There are 4 disease interactions with apixaban.

Major

Factor Xa inhibitors (applies to apixaban) bleeding

Major Potential Hazard, Moderate plausibility.

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.

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Moderate

Factor Xa inhibitors (applies to apixaban) hepatic impairment

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

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.

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Moderate

Factor Xa inhibitors (applies to apixaban) valvular heart disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Prosthetic Heart Valves, Mitral Stenosis

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.

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Moderate

Oral anticoagulants (applies to apixaban) antiphospholipid syndrome

Moderate Potential Hazard, Moderate plausibility.

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.

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Apixaban drug interactions

There are 385 drug interactions with apixaban.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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