Drug interactions
Apixaban + Istradefylline
Severity: Moderate
Apixaban and Istradefylline: moderate 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
At 40 mg/day istradefylline raises exposure to CYP3A4 and P-gp substrates, which may increase apixaban levels and bleeding risk. The effect is not seen at the usual 20 mg/day dose.
What this interaction means in plain words
Apixaban and Istradefylline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Apixaban belongs to Cardiovascular; Istradefylline belongs to Central Nervous System.
Why it happens
Dose-dependent inhibition of CYP3A4 and intestinal P-glycoprotein by istradefylline, reducing apixaban metabolism and efflux.
What to do
Keep istradefylline at 20 mg/day when possible and monitor for bleeding signs. Avoid or reassess the combination if 40 mg/day is used.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Istradefylline
Frequently asked questions
Can I take Apixaban with Istradefylline?
MediHelp rates the interaction as moderate. Apixaban and Istradefylline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. At 40 mg/day istradefylline raises exposure to CYP3A4 and P-gp substrates, which may increase apixaban levels and bleeding risk. The effect is not seen at the usual 20 mg/day dose.
How serious is the interaction between Apixaban and Istradefylline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep istradefylline at 20 mg/day when possible and monitor for bleeding signs. Avoid or reassess the combination if 40 mg/day is used.
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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