Drug interactions
Apalutamide + Apixaban
Severity: Major
Apalutamide and Apixaban: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Apalutamide strongly induces CYP3A4 and P-gp, which lowers apixaban concentrations. Reduced exposure may lead to inadequate anticoagulation and thromboembolic events.
What this interaction means in plain words
Apalutamide and Apixaban can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Apalutamide belongs to Endocrine; Apixaban belongs to Cardiovascular.
Why it happens
Induction of CYP3A4 and P-glycoprotein increases apixaban clearance.
What to do
Avoid the combination where possible and consider an alternative anticoagulant. If used together, monitor for thromboembolic events.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Apixaban
- Apixaban + Dabigatran Contraindicated
- Apixaban + Defibrotide Contraindicated
- Apixaban + Edoxaban Contraindicated
- Apixaban + Ketorolac Contraindicated
- Apixaban + Mifepristone Contraindicated
- Abciximab + Apixaban Major
Other interactions of Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Frequently asked questions
Can I take Apalutamide with Apixaban?
MediHelp rates the interaction as major. Apalutamide and Apixaban can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Apalutamide strongly induces CYP3A4 and P-gp, which lowers apixaban concentrations. Reduced exposure may lead to inadequate anticoagulation and thromboembolic events.
How serious is the interaction between Apalutamide and Apixaban?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and consider an alternative anticoagulant. If used together, monitor for thromboembolic events.
What other medicines interact with Apixaban?
MediHelp also lists interactions of Apixaban with, for example, Dabigatran, Defibrotide, Edoxaban. The full list is on the Apixaban page.
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