Drug interactions
Apixaban + Clopidogrel
Severity: Major
Apixaban and Clopidogrel: major interaction.
Last updated
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
Adding clopidogrel to apixaban increases the risk of major and gastrointestinal bleeding compared with apixaban alone. The combination is sometimes needed, for example after stenting in patients with atrial fibrillation.
What this interaction means in plain words
Apixaban and Clopidogrel 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.
Apixaban belongs to Cardiovascular; Clopidogrel belongs to Cardiovascular.
Why it happens
Additive effects of P2Y12 platelet inhibition and factor Xa inhibition.
What to do
Use only when there is a clear indication, keep the duration of dual therapy as short as possible, and consider a proton pump inhibitor. Monitor for bleeding and hemoglobin.
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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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 Clopidogrel
Frequently asked questions
Can I take Apixaban with Clopidogrel?
MediHelp rates the interaction as major. Apixaban and Clopidogrel 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. Adding clopidogrel to apixaban increases the risk of major and gastrointestinal bleeding compared with apixaban alone. The combination is sometimes needed, for example after stenting in patients with atrial fibrillation.
How serious is the interaction between Apixaban and Clopidogrel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only when there is a clear indication, keep the duration of dual therapy as short as possible, and consider a proton pump inhibitor. Monitor for bleeding and hemoglobin.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
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