Apixaban and Lornoxicam: 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
Lornoxicam
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.
Taking Eliquis (apixaban) with lornoxicam can raise your risk of bleeding. Apixaban is a blood thinner, and lornoxicam is an anti-inflammatory pain medicine (an NSAID). Both can make it harder for your body to stop a bleed, so using them together adds those effects up.
Watch for warning signs like unusual bruising, nosebleeds, pink or red urine, black or bloody stools, or bleeding that won't stop. This concern is based more on how these drugs work than on strong studies, but bleeding is serious, so please don't stop either medicine on your own. Talk with your pharmacist or doctor so they can help you use them safely.
Effect: Additive bleeding risk from combining a direct factor Xa inhibitor (apixaban) with an NSAID (lornoxicam). Neither is a prodrug; this is a pharmacodynamic, not pharmacokinetic, interaction.
- Mechanism: Additive impairment of hemostasis (anticoagulation plus NSAID effects on platelet function and GI mucosa).
- Direction: Increased bleeding risk versus either agent alone, including serious GI bleeds; elevated spinal/epidural hematoma risk with neuraxial anesthesia or spinal puncture.
- Evidence/onset: Theoretical; onset unspecified.
- Management: Assess bleed risk, monitor for signs/symptoms of bleeding, minimize NSAID duration/dose, consider gastroprotection, and use extreme caution around neuraxial procedures.
What happens
An increased risk of bleeding
Interaction Deep Dive
Taking an anticoagulant together with an NSAID can raise the likelihood of serious bleeding compared with either agent used by itself1234, and it can also heighten the chance of epidural or spinal hematomas, which may lead to prolonged or permanent paralysis in patients receiving neuraxial anesthesia or having a spinal puncture5. When the two are given together, watch for signs of bleeding124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
The good news: your care team can manage this. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise.
- Your team may monitor you more closely for bleeding, and the NSAID dose or duration may be adjusted and individualized for you.
- Tell your pharmacist or prescriber you take both, especially before any surgery, spinal injection, or spinal tap, because of the risk of a spinal hematoma.
- Report right away: unusual bruising, nosebleeds, red or black stools, pink or red urine, vomiting blood, or severe headache.
Ask whether a non-NSAID pain option (like acetaminophen) might suit you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Apixaban and Lornoxicam together?
Combining Eliquis (apixaban) with lornoxicam adds up their bleeding risks, so watch closely for signs of bleeding and check with your pharmacist or doctor before changing anything, especially around spinal procedures. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Lornoxicam 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 Lornoxicam interaction managed?
The good news: your care team can manage this. Keep taking both medicines exactly as prescribed unless your doctor tells you otherwise. Your team may monitor you more closely for bleeding, and the NSAID dose or duration may be adjusted and individualized for you. Tell your pharmacist or prescriber you take both, especially before any surgery, spinal injection, or spinal tap, because of the risk of… 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 Lornoxicam 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 Lornoxicam
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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