Drug interactions
Apixaban + Meloxicam
Severity: Major
Apixaban and Meloxicam: 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
Combining an NSAID with apixaban increases the risk of bleeding, particularly gastrointestinal bleeding. NSAIDs impair platelet function and can damage the gastric mucosa while apixaban reduces clotting.
What this interaction means in plain words
Apixaban and Meloxicam 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; Meloxicam belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment: NSAID antiplatelet effect and GI mucosal injury plus factor Xa inhibition.
What to do
Avoid regular NSAID use in anticoagulated patients and choose paracetamol where suitable. If an NSAID is essential, use the lowest dose briefly, consider gastroprotection and monitor 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 Meloxicam
- Ketorolac intranasal + Meloxicam Contraindicated
- Ketorolac + Meloxicam Contraindicated
- Aceclofenac + Meloxicam Major
- Acemetacin + Meloxicam Major
- Acetylsalicylic acid + Meloxicam Major
- Alteplase + Meloxicam 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 Meloxicam?
MediHelp rates the interaction as major. Apixaban and Meloxicam 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. Combining an NSAID with apixaban increases the risk of bleeding, particularly gastrointestinal bleeding. NSAIDs impair platelet function and can damage the gastric mucosa while apixaban reduces clotting.
How serious is the interaction between Apixaban and Meloxicam?
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 choose paracetamol where suitable. If an NSAID is essential, use the lowest dose briefly, consider gastroprotection and monitor for bleeding.
What other medicines interact with Meloxicam?
MediHelp also lists interactions of Meloxicam with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Meloxicam page.
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