Apixaban and Droxicam: 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
Droxicam
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, and droxicam is an anti-inflammatory pain reliever (an NSAID, in the same family as ibuprofen). Each one can make bleeding more likely on its own. When you take them together, that bleeding risk can add up.
Watch for things like unusual bruising, nosebleeds, pink or red urine, black or tarry stools, or bleeding that won't stop. If you ever have back pain, numbness, or weakness after a spinal procedure, get help right away. The good news: your care team can manage this by watching you closely, so please don't stop or change either medicine on your own. Just talk with your pharmacist or doctor.
Effect: Additive bleeding risk when apixaban (direct factor Xa inhibitor) is combined with droxicam (an NSAID). This is a pharmacodynamic interaction, not a metabolic one; neither drug is a prodrug requiring activation. NSAIDs impair platelet function and gastric mucosal integrity, compounding apixaban's anticoagulant effect.
- Direction: increased bleeding risk vs. either agent alone.
- Severity: major; evidence: theoretical/additive.
- Special caution: elevated risk of spinal/epidural hematoma with neuraxial anesthesia or spinal puncture.
- Management: monitor for overt/occult bleeding (CBC, signs/symptoms); consider GI protection or an alternative analgesic; individualize per care team.
What happens
An increased risk of bleeding
Interaction Deep Dive
When an anticoagulant is given together with an NSAID, the likelihood of serious bleeding may rise compared with taking either agent by itself1234. This combination may also heighten the chance of epidural or spinal hematomas, which can lead to lasting or permanent paralysis in individuals undergoing neuraxial anesthesia or spinal puncture5. Should the two be used at the same time, watch for indications of bleeding124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
If both are prescribed together, the priority is keep taking them as directed and let your care team monitor you more closely.
- Your team may check for signs of bleeding and could consider a safer pain option or added stomach protection; any changes should be individualized by them.
- Report unusual bruising, nosebleeds, bleeding gums, pink/red urine, black or tarry stools, or coughing up blood.
- If you are scheduled for a spinal injection, epidural, or spinal tap, tell the provider you take both drugs, because of the risk of a spinal blood clot.
- Don't start, stop, or change either medicine on your own; check with your pharmacist or prescriber first.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Apixaban and Droxicam together?
Apixaban plus droxicam adds up to a higher bleeding risk, so watch for any signs of bleeding and keep both drugs under your care team's supervision. Don't change anything on your own; talk with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Droxicam 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 Droxicam interaction managed?
If both are prescribed together, the priority is keep taking them as directed and let your care team monitor you more closely. Your team may check for signs of bleeding and could consider a safer pain option or added stomach protection; any changes should be individualized by them. Report unusual bruising, nosebleeds, bleeding gums, pink/red urine, black or tarry stools, or coughing up blood. If y… 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 Droxicam 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 (5)
- Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
- Product Information: CELEBREX(R) oral capsules, celecoxib oral capsules. GD Searle LLC (per FDA), New York, NY, 2016. DailyMed
- Product Information: COUMADIN(R) oral tablets, intravenous injection powder for solution, warfarin sodium oral tablets, intravenous injection powder for solution. Bristol-Myers Squibb Company (per manufacturer), Princeton, NJ, 2015. DailyMed
- Product Information: COMBOGESIC(R) oral tablets, acetaminophen ibuprofen oral tablets. AFT Pharmaceuticals Inc (per FDA), Highland, MD, 2023. DailyMed
- Product Information: PRADAXA(R) oral capsules, dabigatran etexilate oral capsules. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2023. DailyMed
Keep reading about Apixaban
Keep reading about Droxicam
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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