6 known interactions • 4 major • 2 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Strong dual CYP3A4 + P-gp inhibitors (ketoconazole, ritonavir, itraconazole, clarithromycin)
Combination raises apixaban AUC by up to 2-fold, significantly increasing bleeding risk.
Management: Reduce apixaban to 2.5 mg twice daily if patient is on standard dose; avoid if on 2.5 mg.
Strong dual CYP3A4 + P-gp inducers (rifampin, carbamazepine, phenytoin, St. John's Wort)
Reduce apixaban exposure by ~54%, risking thromboembolic events.
Management: Avoid concurrent use. Consider parenteral anticoagulation if urgent.
Aspirin and NSAIDs
Antiplatelet/anticoagulant combination increases major bleeding risk substantially.
Management: Use lowest possible aspirin dose; avoid NSAIDs. Use gastric protection if combination essential.
Other anticoagulants / antiplatelets (warfarin, clopidogrel, heparin)
Additive anticoagulation significantly raises bleeding risk.
Management: Avoid combinations unless carefully supervised (e.g., ACS bridge therapy).
Moderate CYP3A4/P-gp inhibitors (fluconazole, diltiazem, amiodarone)
May increase apixaban levels by ~30–50%.
Management: Use with caution; no dose adjustment required but monitor for bleeding signs.
P-gp + weak CYP3A4 inducers (nafcillin, apalutamide)
May reduce apixaban exposure moderately.
Management: Monitor for loss of anticoagulation efficacy; consider dose adjustment if needed.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Eliquis. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.