Drug interactions
Apixaban + Flurbiprofen
Severity: Major
Apixaban and Flurbiprofen: 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
Flurbiprofen taken with apixaban increases the risk of bleeding, particularly gastrointestinal bleeding. The legacy suggestion of reduced anticoagulation is not the clinical concern.
What this interaction means in plain words
Apixaban and Flurbiprofen 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; Flurbiprofen belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment through NSAID platelet inhibition and mucosal injury combined with factor Xa inhibition.
What to do
Avoid regular NSAID use in patients on apixaban and use paracetamol instead. If an NSAID is unavoidable, use the shortest course, consider gastroprotection and monitor for bleeding and anemia.
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 Flurbiprofen
- Flurbiprofen + Ketorolac Contraindicated
- Flurbiprofen + Ketorolac intranasal Contraindicated
- Aceclofenac + Flurbiprofen Major
- Acemetacin + Flurbiprofen Major
- Acetylsalicylic acid + Flurbiprofen Major
- Alteplase + Flurbiprofen 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 Flurbiprofen?
MediHelp rates the interaction as major. Apixaban and Flurbiprofen 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. Flurbiprofen taken with apixaban increases the risk of bleeding, particularly gastrointestinal bleeding. The legacy suggestion of reduced anticoagulation is not the clinical concern.
How serious is the interaction between Apixaban and Flurbiprofen?
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 regular NSAID use in patients on apixaban and use paracetamol instead. If an NSAID is unavoidable, use the shortest course, consider gastroprotection and monitor for bleeding and anemia.
What other medicines interact with Flurbiprofen?
MediHelp also lists interactions of Flurbiprofen with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Flurbiprofen page.
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