Apixaban and Abiraterone Acetate: 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
Abiraterone Acetate
Apixaban
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.
Here's what's going on. Apixaban (Eliquis) is a blood thinner. Abiraterone can slow down a natural "pump" in your body that helps clear apixaban out. When that pump is blocked, more apixaban can build up in your blood, which may raise your risk of bleeding, things like easy bruising, nosebleeds, or bleeding that is hard to stop.
I want to be clear that this concern comes from how these drugs are expected to behave, not from strong studies, so it is more of a caution than a proven problem. Please don't stop either medicine on your own. Talk with your doctor or pharmacist. They can decide the safest plan and keep a close eye on you.
Mechanism: Abiraterone is a potential P-glycoprotein (P-gp) inhibitor; apixaban is a P-gp substrate. Inhibition of P-gp-mediated efflux may reduce apixaban clearance and increase its systemic exposure (AUC/Cmax), raising bleeding risk. Neither agent requires activation, so this is a straightforward exposure increase.
- Direction: increased apixaban effect (bleeding risk)
- Evidence: theoretical; magnitude not quantified
- Onset: unspecified
- Severity: major; guidance on file is to avoid coadministration
Management: Avoid the combination where feasible. If used together, monitor closely for signs/symptoms of bleeding; dosing should be individualized by the care team. Consider an alternative anticoagulant if clinically appropriate.
What happens
Increased apixaban exposure
Interaction Deep Dive
Taking apixaban (a substrate of P-gp) together with abiraterone (a possible P-gp inhibitor) can raise apixaban concentrations and heighten the likelihood of bleeding, so the two agents should not be given together1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of apixaban
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. The documented advice is that this combination is generally best avoided, so this is worth a conversation.
- Ask your prescriber or pharmacist whether these two should be used together or whether a different option is safer for you.
- If you do stay on both, your team may watch you more closely for bleeding, and your dose may need to be adjusted and individualized.
- Report any unusual bruising, nosebleeds, blood in urine or stool, black stools, or bleeding that won't stop.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Apixaban and Abiraterone Acetate together?
Abiraterone may raise apixaban levels and bleeding risk, so this combination is best avoided; check with your doctor or pharmacist before making any changes, and watch for signs of bleeding. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Abiraterone Acetate 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 Apixaban and Abiraterone Acetate interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. The documented advice is that this combination is generally best avoided, so this is worth a conversation. Ask your prescriber or pharmacist whether these two should be used together or whether a different option is safer for you. If you do stay on both, your team may watch you more closely for bleeding, and your d… 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 Apixaban or Abiraterone Acetate 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 (1)
- Steffel J, Collins R, Antz M, et al: 2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Europace 2021; 23(10):1612-1676.
Keep reading about Abiraterone Acetate
Keep reading about Apixaban
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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