Apixaban and Loxoprofen: 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
Loxoprofen
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 loxoprofen is an anti-inflammatory painkiller (an NSAID) similar to ibuprofen. Both of these can make bleeding more likely on their own. When taken together, that bleeding risk can add up, so you may bruise more easily or bleed a bit more than usual.
This is based mostly on how these medicines work rather than lots of studies, but it is worth taking seriously. Watch for things like unusual bruising, nosebleeds, pink or red urine, black stools, or bleeding that will not stop. The good news is your care team can manage this. Keep taking both as prescribed, and talk with your pharmacist or doctor about your pain options and what to watch for.
Effect: Additive bleeding risk from combining a factor Xa inhibitor (apixaban) with an NSAID (loxoprofen). Neither is a prodrug relevant here; this is a pharmacodynamic, not pharmacokinetic, interaction.
- Mechanism: Additive impairment of hemostasis (anticoagulation plus NSAID-mediated platelet inhibition and GI mucosal injury).
- Direction/magnitude: Increased risk of serious bleeding vs either agent alone; magnitude not quantified.
- Onset: Unspecified. Evidence: Theoretical.
- Management: Monitor for signs/symptoms of bleeding (GI, mucocutaneous). Heightened caution with neuraxial anesthesia/spinal puncture given spinal/epidural hematoma risk. Consider GI protection or alternative analgesia per prescriber.
What happens
An increased risk of bleeding
Interaction Deep Dive
Using an anticoagulant together with an NSAID can raise the likelihood of serious bleeding compared with taking either agent by itself1234, and in patients undergoing neuraxial anesthesia or spinal puncture it can heighten the risk of epidural or spinal hematomas, which may lead to prolonged or permanent paralysis5. When these drugs are given together, watch for signs of bleeding124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
Keep taking both exactly as prescribed unless your care team tells you otherwise. Because a blood thinner and an NSAID together can raise bleeding risk, your team may watch you more closely and tailor your treatment.
- Watch for and report unusual bruising, nosebleeds, bleeding gums, pink/red urine, black or bloody stools, or vomiting that looks like coffee grounds.
- Ask your pharmacist or doctor whether a different pain reliever or added stomach protection is right for you.
- If you are scheduled for a spinal injection, epidural, or spinal tap, make sure the team knows you take both drugs, since this combination raises the risk of a spinal blood clot.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Apixaban and Loxoprofen together?
Taking apixaban with loxoprofen can add up to more bleeding risk, so watch for any signs of bleeding and ask your pharmacist or doctor about safer pain options and whether you need extra monitoring. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Loxoprofen 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 Loxoprofen interaction managed?
Keep taking both exactly as prescribed unless your care team tells you otherwise. Because a blood thinner and an NSAID together can raise bleeding risk, your team may watch you more closely and tailor your treatment. Watch for and report unusual bruising, nosebleeds, bleeding gums, pink/red urine, black or bloody stools, or vomiting that looks like coffee grounds. Ask your pharmacist or doctor whe… 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 Loxoprofen 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 Loxoprofen
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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