Apixaban; Rivaroxaban/P-gp and Strong CYP3A4 Inducers Interactions

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:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Some medicines, including apalutamide, carbamazepine, efavirenz, fosphenytoin, phenobarbital, phenytoin, primidone, rifampin, and St. John's wort, may cause your body to process apixaban and rivaroxaban more quickly.

What might happen:

The effects of apixaban and rivaroxaban may decrease and increase your risk for blood clots. If you stop taking your other medicine, there is an increased chance for bleeding.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) about taking these two medicines together or if you have taken apalutamide, carbamazepine, efavirenz, fosphenytoin, phenobarbital, phenytoin, primidone, rifampin, or St. John's wort in the previous two weeks. Your dose of apixaban or rivaroxaban may need adjusting, especially if your doctor stops your other medicine. If you experience bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor.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.

  • 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 March 12, 2019.
  • 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 June, 2019.
  • 5.Xarelto (rivaroxaban) US prescribing information. Janssen Pharmaceuticals, Inc. August, 2019.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.