Drug interactions
Apixaban + Inotersen
Severity: Major
Apixaban and Inotersen: major interaction.
Last updated Sources: EMA SmPC
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
Inotersen can cause sudden and severe thrombocytopenia, and apixaban is an anticoagulant. Combined use raises the risk of serious bleeding.
What this interaction means in plain words
Apixaban and Inotersen 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; Inotersen belongs to Miscellaneous.
Why it happens
Additive bleeding risk: inotersen-induced thrombocytopenia plus factor Xa inhibition.
What to do
Follow the label platelet monitoring schedule and interrupt inotersen if platelets fall below the stated thresholds. Reassess the need for anticoagulation and teach patients to report 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 Inotersen
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 Inotersen?
MediHelp rates the interaction as major. Apixaban and Inotersen 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. Inotersen can cause sudden and severe thrombocytopenia, and apixaban is an anticoagulant. Combined use raises the risk of serious bleeding.
How serious is the interaction between Apixaban and Inotersen?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Follow the label platelet monitoring schedule and interrupt inotersen if platelets fall below the stated thresholds. Reassess the need for anticoagulation and teach patients to report bleeding.
What other medicines interact with Inotersen?
MediHelp also lists interactions of Inotersen with, for example, Acetylsalicylic acid, Clopidogrel, Rivaroxaban. The full list is on the Inotersen page.
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