Apixaban and Felbinac: 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
Felbinac
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 helps prevent dangerous clots. Felbinac is an anti-inflammatory pain reliever (an NSAID). When these two are used together, they can both work against your body's ability to stop bleeding, so the combined effect may raise your risk of bleeding more than either one alone.
This is a theoretical concern, meaning it is based on how these drugs work rather than lots of direct studies, but bleeding is serious enough that we take it seriously. Watch for things like unusual bruising, nosebleeds, pink or dark urine, or black stools. Please don't stop either medicine on your own. Your care team can manage this safely by keeping an eye on you.
Interaction: Additive effect on hemostasis. Apixaban is a direct factor Xa inhibitor; felbinac is an NSAID with antiplatelet activity and GI mucosal effects. Neither is a prodrug in a way that alters direction, this is a pharmacodynamic (not PK) interaction, so combined use additively increases bleeding risk.
- Direction: Increased bleeding risk versus either agent alone.
- Evidence: Theoretical; mechanistically well supported.
- Severity/onset: Major; onset unspecified.
- Management: Monitor for signs of bleeding (GI, mucocutaneous, anemia). Heightened caution with neuraxial anesthesia or spinal puncture given epidural/spinal hematoma risk. Individualize therapy with prescriber.
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, and there may be a greater chance of epidural or spinal hematomas, which can lead to prolonged or permanent paralysis, in individuals receiving neuraxial anesthesia or undergoing 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
The main tool here is careful monitoring rather than a fixed dose change. Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Watch for and report bleeding signs: unusual bruising, nosebleeds, bleeding gums, pink or red urine, black or bloody stools, or feeling unusually weak or dizzy.
- Tell your care team you take both drugs, especially before any spinal injection, spinal tap, or epidural, because of a rare risk of spinal bleeding.
- Ask your pharmacist whether an alternative pain reliever might be safer for you.
Your team may monitor you more closely and tailor your treatment to keep you safe.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Apixaban and Felbinac together?
Using the blood thinner apixaban with the NSAID felbinac can add up to a higher bleeding risk, so watch closely for bleeding and keep your care team informed rather than changing anything on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Felbinac 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 Felbinac interaction managed?
The main tool here is careful monitoring rather than a fixed dose change. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Watch for and report bleeding signs: unusual bruising, nosebleeds, bleeding gums, pink or red urine, black or bloody stools, or feeling unusually weak or dizzy. Tell your care team you take both drugs, especially before any spinal injection, s… 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 Felbinac 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 Felbinac
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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