Drug interactions
Apixaban + Diltiazem
Severity: Moderate
Apixaban and Diltiazem: moderate 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
Diltiazem modestly increases apixaban exposure, which may raise bleeding risk, especially in renal impairment or older patients.
What this interaction means in plain words
Apixaban and Diltiazem can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Apixaban belongs to Cardiovascular; Diltiazem belongs to Cardiovascular.
Why it happens
Diltiazem is a moderate CYP3A4 and weak P-glycoprotein inhibitor, reducing apixaban clearance.
What to do
No routine dose change is needed, but monitor for bleeding, and reassess the benefit-risk balance in patients with renal impairment.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Other interactions of Apixaban
- Apixaban + Dabigatran Contraindicated
- Apixaban + Defibrotide Contraindicated
- Apixaban + Edoxaban Contraindicated
- Apixaban + Ketorolac Contraindicated
- Apixaban + Mifepristone Contraindicated
- Abciximab + Apixaban Major
Frequently asked questions
Can I take Apixaban with Diltiazem?
MediHelp rates the interaction as moderate. Apixaban and Diltiazem can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Diltiazem modestly increases apixaban exposure, which may raise bleeding risk, especially in renal impairment or older patients.
How serious is the interaction between Apixaban and Diltiazem?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed, but monitor for bleeding, and reassess the benefit-risk balance in patients with renal impairment.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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