Drug interactions
Apixaban + Efavirenz
Severity: Moderate
Apixaban and Efavirenz: 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
Efavirenz may lower apixaban exposure because apixaban is partly cleared through CYP3A4 and P-gp. Reduced anticoagulant effect could increase the risk of thromboembolism.
What this interaction means in plain words
Apixaban and Efavirenz 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; Efavirenz belongs to Anti Virals.
Why it happens
Efavirenz induction of CYP3A4 and P-glycoprotein increases apixaban clearance.
What to do
Monitor for thrombotic events and consider an alternative anticoagulant when a stable effect is critical. Apixaban labeling advises avoiding combined strong dual inducers where possible.
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 Efavirenz
- Cobimetinib + Efavirenz Contraindicated
- Dienogest / estradiol valerate + Efavirenz Contraindicated
- Dihydroergotamine intranasal + Efavirenz Contraindicated
- Dihydroergotamine + Efavirenz Contraindicated
- Doravirine + Efavirenz Contraindicated
- Efavirenz + Elbasvir / grazoprevir Contraindicated
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 Efavirenz?
MediHelp rates the interaction as moderate. Apixaban and Efavirenz 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. Efavirenz may lower apixaban exposure because apixaban is partly cleared through CYP3A4 and P-gp. Reduced anticoagulant effect could increase the risk of thromboembolism.
How serious is the interaction between Apixaban and Efavirenz?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for thrombotic events and consider an alternative anticoagulant when a stable effect is critical. Apixaban labeling advises avoiding combined strong dual inducers where possible.
What other medicines interact with Efavirenz?
MediHelp also lists interactions of Efavirenz with, for example, Cobimetinib, Dienogest / estradiol valerate, Dihydroergotamine intranasal. The full list is on the Efavirenz page.
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