Drug interactions
Apixaban + Nabumetone
Severity: Major
Apixaban and Nabumetone: major interaction.
Last updated Sources: Base de donnees publique des medicaments (France)
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
Nabumetone adds to the bleeding risk of apixaban, increasing the likelihood of gastrointestinal and other bleeding. The risk is higher in older patients and those with prior ulcer disease.
What this interaction means in plain words
Apixaban and Nabumetone 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; Nabumetone belongs to Musculoskeletal.
Why it happens
NSAID inhibition of platelet function and gastric mucosal injury add to the anticoagulant effect of factor Xa inhibition.
What to do
Avoid regular NSAID use in patients on apixaban and choose paracetamol where possible. If unavoidable, use the shortest course, consider gastroprotection and monitor for signs of bleeding and hemoglobin changes.
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 Nabumetone
- Ketorolac intranasal + Nabumetone Contraindicated
- Ketorolac + Nabumetone Contraindicated
- Aceclofenac + Nabumetone Major
- Acemetacin + Nabumetone Major
- Acetylsalicylic acid + Nabumetone Major
- Alteplase + Nabumetone 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 Nabumetone?
MediHelp rates the interaction as major. Apixaban and Nabumetone 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. Nabumetone adds to the bleeding risk of apixaban, increasing the likelihood of gastrointestinal and other bleeding. The risk is higher in older patients and those with prior ulcer disease.
How serious is the interaction between Apixaban and Nabumetone?
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 patients on apixaban and choose paracetamol where possible. If unavoidable, use the shortest course, consider gastroprotection and monitor for signs of bleeding and hemoglobin changes.
What other medicines interact with Nabumetone?
MediHelp also lists interactions of Nabumetone with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Nabumetone page.
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