Abciximab and Apixaban: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Aug 8, 2026 · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Apixaban
Abciximab
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Apixaban (Eliquis) is a blood thinner that lowers your body's ability to form clots. Abciximab is a different kind of clot-blocker given in the hospital during certain heart procedures. When they are used together, their effects add up, so bleeding becomes more likely. This could show up as easy bruising, nosebleeds, blood in your urine or stool, or bleeding that is hard to stop.
The good news is that your care team knows about this. In fact, abciximab usually isn't given if you've recently taken an oral blood thinner unless your clotting tests look safe. Your team can watch you closely and tailor your treatment, so let them know every medicine you take.
Effect: Additive risk of major bleeding from combined effects on hemostasis. Apixaban (direct oral factor Xa inhibitor) plus abciximab (GPIIb/IIIa inhibitor antiplatelet) produces overlapping pharmacodynamic inhibition of clot formation. Neither is a prodrug; this is a PD interaction, not PK.
- Direction: Increased bleeding risk (additive).
- Severity/Evidence: Major; theoretical/mechanistic basis.
- Onset: Unspecified.
- Management: Abciximab is contraindicated in patients who received oral anticoagulants within 7 days unless PT is less than or equal to 1.2x control. If coadministration is required, monitor closely for clinical signs and symptoms of bleeding.
What happens
An increased risk of bleeding
Interaction Deep Dive
Taking abciximab (an antiplatelet drug) together with an anticoagulant can raise the likelihood of major bleeding because the anticoagulant effects are additive12. In patients who have taken oral anticoagulants during the preceding seven days, abciximab should not be used unless the prothrombin time is at or below 1.2 times control1. When simultaneous anticoagulant therapy cannot be avoided, watch patients for clinical signs and symptoms indicating bleeding3.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
Both drugs reduce clotting, so used together they raise bleeding risk. Your care team manages this carefully.
- Abciximab is generally not given if you've taken an oral anticoagulant like apixaban in the past week unless clotting tests (prothrombin time) are within a safe range.
- If both must be used, your team will watch you closely for signs of bleeding.
- Do not start, stop, or change either medicine on your own.
- Tell every provider you take apixaban, and report unusual bruising, bleeding that won't stop, blood in urine or stool, or black stools right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In two drug interaction studies in which clopidogrel (an antiplatelet agent) was given as a 300 mg loading dose followed by a 75 mg daily maintenance dose together with rivaroxaban (a factor Xa inhibitor and anticoagulant) as a single 15 mg dose in healthy subjects, bleeding time rose to 45 minutes in roughly 45% and 30% of subjects in these respective studies. This alteration in bleeding time was about double the greatest increase observed with either agent used on its own. Neither drug showed any change in its pharmacokinetics 3.
Common questions
Can I take Abciximab and Apixaban together?
Combining apixaban and abciximab adds up their blood-thinning effects and raises the risk of serious bleeding, so this pairing is used only with caution and close monitoring by your care team. Report any unusual bleeding right away. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abciximab and Apixaban interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abciximab and Apixaban interaction managed?
Both drugs reduce clotting, so used together they raise bleeding risk. Your care team manages this carefully. Abciximab is generally not given if you've taken an oral anticoagulant like apixaban in the past week unless clotting tests (prothrombin time) are within a safe range. If both must be used, your team will watch you closely for signs of bleeding. Do not start, stop, or change either medicin… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Abciximab or Apixaban need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: REOPRO(R) IV injection, abciximab IV injection. Eli Lilly and Company, Indianapolis, IN, 2005.
- Product Information: LOVENOX(R) solution for subcutaneous and intravenous injection, enoxaparin sodium solution for subcutaneous and intravenous injection. Sanofi-Aventis, Bridgewater, NJ, 2009. DailyMed
- Product Information: XARELTO(R) oral tablets, oral suspension, rivaroxaban oral tablets, oral suspension. Janssen Pharmaceuticals Inc (per FDA), Titusville, NJ, 2023. DailyMed
Keep reading about Apixaban
Keep reading about Abciximab
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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