Drug interactions
Acetylsalicylic acid + Enoxaparin
Severity: Major
Acetylsalicylic acid and Enoxaparin: 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
Aspirin with enoxaparin increases the risk of bleeding, including major hemorrhage. The combination is often intended in acute coronary syndromes, but the bleeding risk is real.
What this interaction means in plain words
Acetylsalicylic acid and Enoxaparin 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.
Acetylsalicylic acid belongs to Musculoskeletal; Enoxaparin belongs to Cardiovascular.
Why it happens
Additive hemostatic impairment from anti-factor Xa anticoagulation and aspirin's platelet inhibition.
What to do
Use only for clear indications, with low-dose aspirin and standard enoxaparin dosing adjusted for renal function. Monitor for bleeding and check hemoglobin and platelet counts.
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 Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Alteplase + Enoxaparin Major
Frequently asked questions
Can I take Acetylsalicylic acid with Enoxaparin?
MediHelp rates the interaction as major. Acetylsalicylic acid and Enoxaparin 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. Aspirin with enoxaparin increases the risk of bleeding, including major hemorrhage. The combination is often intended in acute coronary syndromes, but the bleeding risk is real.
How serious is the interaction between Acetylsalicylic acid and Enoxaparin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only for clear indications, with low-dose aspirin and standard enoxaparin dosing adjusted for renal function. Monitor for bleeding and check hemoglobin and platelet counts.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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