Drug interactions
Apixaban + Prothrombin complex concentrate human
Severity: Major
Apixaban and Prothrombin complex concentrate human: major 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
Prothrombin complex concentrate is given to reverse the anticoagulant effect of factor Xa inhibitors such as apixaban. Given together outside a reversal setting, the two work against each other, and the concentrate adds a risk of thrombosis. Reversal use in life-threatening bleeding is a recognised indication, so the pair is not an absolute contraindication.
What this interaction means in plain words
Apixaban and Prothrombin complex concentrate human 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.
Why it happens
Pharmacodynamic antagonism: the concentrate supplies clotting factors that counteract factor Xa inhibition, with a prothrombotic potential.
What to do
Reserve the concentrate for apixaban-related life-threatening or uncontrolled bleeding, using the lowest effective dose. Monitor for thromboembolic events and restart anticoagulation as soon as it is safe.
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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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 Prothrombin complex concentrate human?
MediHelp rates the interaction as major. Apixaban and Prothrombin complex concentrate human 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. Prothrombin complex concentrate is given to reverse the anticoagulant effect of factor Xa inhibitors such as apixaban. Given together outside a reversal setting, the two work against each other, and the concentrate adds a risk of thrombosis. Reversal use in life-threatening bleeding is a recognised indication, so the pair is not an absolute contraindication.
How serious is the interaction between Apixaban and Prothrombin complex concentrate human?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the concentrate for apixaban-related life-threatening or uncontrolled bleeding, using the lowest effective dose. Monitor for thromboembolic events and restart anticoagulation as soon as it is safe.
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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