Apixaban; Rivaroxaban/P-gp and Strong CYP 3A4 Inhibitors
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Some medicines may slow down how quickly your body processes your anticoagulant.
What might happen:
The amount of anticoagulant in your blood may increase, which may increase your risk of bleeding, including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together. If you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Eliquis (apixaban) Australian prescribing information. Bristol-Myers Squibb Australia Pty. Ltd. July 21, 2011.
2.Eliquis (apixaban) Canadian prescribing information. Bristol-Myers Squibb-Pfizer December, 13, 2011.
3.Eliquis (apixaban) UK summary of product characterstics. Bristol-Myers Squibb/Pfizer EEIG, Bristol-Myers Squibb House November 19, 2012.
4.Eliquis (apixaban) US prescribing information. Bristol-Myers Squibb Company December, 2012.
5.Xarelto (rivaroxaban) Canadian prescribing information. Bayer September 10, 2008.
6.Xarelto (rivaroxaban) US prescribing information. Janssen Pharmaceuticals, Inc. July, 2011.
7.Xarelto (rivaroxaban) UK summary of product characteristics. Bayer Schering Pharma September, 2008.
8.Norvir (ritonavir) US prescribing information. Abbott Laboratories November, 2012.





