Drug interactions
Apixaban + Posaconazole
Severity: Major
Apixaban and Posaconazole: major interaction.
Last updated Sources: UK 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
Posaconazole is a strong CYP3A4 and P-glycoprotein inhibitor, which increases apixaban exposure and the risk of bleeding.
What this interaction means in plain words
Apixaban and Posaconazole 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; Posaconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein reduces apixaban clearance and increases absorption.
What to do
For patients on more than 2.5 mg twice daily, reduce the apixaban dose by half; if already on 2.5 mg twice daily, avoid the combination. 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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
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 Posaconazole?
MediHelp rates the interaction as major. Apixaban and Posaconazole 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. Posaconazole is a strong CYP3A4 and P-glycoprotein inhibitor, which increases apixaban exposure and the risk of bleeding.
How serious is the interaction between Apixaban and Posaconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: For patients on more than 2.5 mg twice daily, reduce the apixaban dose by half; if already on 2.5 mg twice daily, avoid the combination. Monitor for bleeding.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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