Drug interactions
Apixaban + Heparin
Severity: Major
Apixaban and Heparin: 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
Combining two anticoagulants increases the risk of major bleeding. Brief overlap occurs in practice when transitioning between agents, but sustained concurrent use is not intended.
What this interaction means in plain words
Apixaban and Heparin 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; Heparin belongs to Cardiovascular.
Why it happens
Additive anticoagulation through antithrombin-mediated inhibition (heparin) and direct factor Xa inhibition (apixaban).
What to do
Avoid concurrent therapeutic use; when switching, start apixaban when the infusion is stopped, and monitor for bleeding.
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 Heparin
- Defibrotide + Heparin Contraindicated
- Heparin + Ketorolac Contraindicated
- Heparin + Oritavancin Contraindicated
- Acemetacin + Heparin Major
- Acetylsalicylic acid + Heparin Major
- Alteplase + Heparin 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 Heparin?
MediHelp rates the interaction as major. Apixaban and Heparin 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. Combining two anticoagulants increases the risk of major bleeding. Brief overlap occurs in practice when transitioning between agents, but sustained concurrent use is not intended.
How serious is the interaction between Apixaban and Heparin?
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 concurrent therapeutic use; when switching, start apixaban when the infusion is stopped, and monitor for bleeding.
What other medicines interact with Heparin?
MediHelp also lists interactions of Heparin with, for example, Defibrotide, Ketorolac, Oritavancin. The full list is on the Heparin page.
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