Drug interactions
Apixaban + Tipranavir
Severity: Major
Apixaban and Tipranavir: 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
Tipranavir with ritonavir inhibits CYP3A4 and P-gp, though tipranavir itself also has inducing effects, making the net effect on apixaban unpredictable. Increased apixaban exposure and bleeding is the main concern.
What this interaction means in plain words
Apixaban and Tipranavir 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; Tipranavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted tipranavir inhibits CYP3A4 and P-gp, with mixed inductive effects, altering apixaban clearance.
What to do
Avoid where possible or choose an alternative anticoagulant; if combined, monitor closely for bleeding and thrombosis.
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 Apixaban
- Apixaban + Dabigatran Contraindicated
- Apixaban + Defibrotide Contraindicated
- Apixaban + Edoxaban Contraindicated
- Apixaban + Ketorolac Contraindicated
- Apixaban + Mifepristone Contraindicated
- Abciximab + Apixaban Major
Other interactions of Tipranavir
- Alfuzosin + Tipranavir Contraindicated
- Amiodarone + Tipranavir Contraindicated
- Atorvastatin + Tipranavir Contraindicated
- Avanafil + Tipranavir Contraindicated
- Cisapride + Tipranavir Contraindicated
- Colchicine + Tipranavir Contraindicated
Frequently asked questions
Can I take Apixaban with Tipranavir?
MediHelp rates the interaction as major. Apixaban and Tipranavir 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. Tipranavir with ritonavir inhibits CYP3A4 and P-gp, though tipranavir itself also has inducing effects, making the net effect on apixaban unpredictable. Increased apixaban exposure and bleeding is the main concern.
How serious is the interaction between Apixaban and Tipranavir?
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 where possible or choose an alternative anticoagulant; if combined, monitor closely for bleeding and thrombosis.
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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