Drug interactions
Apixaban + Indinavir
Severity: Major
Apixaban and Indinavir: 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
Indinavir is a potent CYP3A4 inhibitor and can increase apixaban exposure, raising the risk of bleeding. Apixaban labeling advises dose reduction or avoidance with combined strong CYP3A4 and P-gp inhibitors, and indinavir is mainly a CYP3A4 inhibitor.
What this interaction means in plain words
Apixaban and Indinavir 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.
Why it happens
Inhibition of CYP3A4 (and possibly P-glycoprotein) reduces apixaban clearance.
What to do
Avoid the combination where possible or use an alternative antiretroviral. If it is unavoidable, follow apixaban labeling for dose reduction and monitor closely 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 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 Indinavir?
MediHelp rates the interaction as major. Apixaban and Indinavir 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. Indinavir is a potent CYP3A4 inhibitor and can increase apixaban exposure, raising the risk of bleeding. Apixaban labeling advises dose reduction or avoidance with combined strong CYP3A4 and P-gp inhibitors, and indinavir is mainly a CYP3A4 inhibitor.
How serious is the interaction between Apixaban and Indinavir?
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 the combination where possible or use an alternative antiretroviral. If it is unavoidable, follow apixaban labeling for dose reduction and monitor closely for bleeding.
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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