Drug interactions
Apixaban + Ibuprofen
Severity: Major
Apixaban and Ibuprofen: 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
Ibuprofen combined with apixaban increases the risk of bleeding, particularly gastrointestinal haemorrhage. The risk arises from both platelet inhibition and gastric mucosal injury added to anticoagulation.
What this interaction means in plain words
Apixaban and Ibuprofen 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; Ibuprofen belongs to Musculoskeletal.
Why it happens
Additive pharmacodynamic effect: NSAID antiplatelet action and mucosal damage plus factor Xa inhibition.
What to do
Avoid regular NSAID use in anticoagulated patients and use paracetamol for analgesia where possible. If unavoidable, use the shortest course with gastroprotection and monitor for bleeding and anaemia.
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 Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Argatroban + Ibuprofen 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 Ibuprofen?
MediHelp rates the interaction as major. Apixaban and Ibuprofen 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. Ibuprofen combined with apixaban increases the risk of bleeding, particularly gastrointestinal haemorrhage. The risk arises from both platelet inhibition and gastric mucosal injury added to anticoagulation.
How serious is the interaction between Apixaban and Ibuprofen?
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 anticoagulated patients and use paracetamol for analgesia where possible. If unavoidable, use the shortest course with gastroprotection and monitor for bleeding and anaemia.
What other medicines interact with Ibuprofen?
MediHelp also lists interactions of Ibuprofen with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Ibuprofen page.
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