Drug interactions
Apixaban + Ibrutinib
Severity: Major
Apixaban and Ibrutinib: 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
Ibrutinib impairs platelet function and has been associated with bleeding, including major hemorrhage. With apixaban the bleeding risk is increased, and ibrutinib is also a weak P-glycoprotein inhibitor.
What this interaction means in plain words
Apixaban and Ibrutinib 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; Ibrutinib belongs to Oncology.
Why it happens
Additive pharmacodynamic effect from BTK-mediated platelet inhibition plus factor Xa inhibition, with possible minor P-glycoprotein inhibition.
What to do
Monitor closely for bleeding and check blood counts regularly. Consider an alternative anticoagulant or temporary interruption of ibrutinib around procedures or if bleeding occurs.
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 Ibrutinib
- Abciximab + Ibrutinib Major
- Acetylsalicylic acid + Ibrutinib Major
- Alteplase + Ibrutinib Major
- Amobarbital + Ibrutinib Major
- Apalutamide + Ibrutinib Major
- Bosentan + Ibrutinib Major
Frequently asked questions
Can I take Apixaban with Ibrutinib?
MediHelp rates the interaction as major. Apixaban and Ibrutinib 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. Ibrutinib impairs platelet function and has been associated with bleeding, including major hemorrhage. With apixaban the bleeding risk is increased, and ibrutinib is also a weak P-glycoprotein inhibitor.
How serious is the interaction between Apixaban and Ibrutinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor closely for bleeding and check blood counts regularly. Consider an alternative anticoagulant or temporary interruption of ibrutinib around procedures or if bleeding occurs.
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.
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