Apixaban and Proquazone: 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
Proquazone
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 these two together can raise your risk of bleeding. Apixaban (Eliquis) is a blood thinner. Proquazone is an anti-inflammatory pain medicine (an NSAID). Both can make it harder for your blood to clot, so using them together may cause more bleeding than either one alone. This includes things like easy bruising, nosebleeds, or bleeding in the stomach.
The good news is your care team can manage this. Please keep taking both exactly as prescribed, and watch for any unusual bleeding. Let your pharmacist or doctor know if you notice anything, and be sure to mention this combination before any spinal procedure or surgery.
Mechanism: Additive pharmacodynamic effect on hemostasis. Apixaban is a direct factor Xa inhibitor; proquazone is an NSAID with antiplatelet and GI mucosal effects. Neither is a prodrug, so the interaction is a PD (not PK) additive bleeding risk, not a metabolic effect.
- Direction: Increased bleeding risk versus either agent alone.
- Evidence: Theoretical; severity rated major.
- Onset: Unspecified.
- Key concern: Elevated risk of serious/GI bleeding, and spinal or epidural hematoma with neuraxial anesthesia or spinal puncture.
Management: If used concomitantly, monitor closely for signs of bleeding; assess GI protection needs and hold/plan around neuraxial procedures.
What happens
An increased risk of bleeding
Interaction Deep Dive
When an anticoagulant is taken together with an NSAID, the likelihood of serious bleeding may rise compared with taking either agent by itself1234. In patients receiving neuraxial anesthesia or undergoing spinal puncture, this combination may also heighten the chance of epidural or spinal hematomas, which can lead to prolonged or permanent paralysis5. Should the two drugs be given at the same time, watch for indications of bleeding124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
Your care team can keep this combination safe by tailoring your plan and watching you more closely.
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Watch for bleeding: unusual bruising, nosebleeds, pink or red urine, black or bloody stools, or bleeding that will not stop. Report these right away.
- Before any spinal or epidural procedure or surgery, tell the team you take both drugs, because of a rare risk of spinal bleeding.
- Ask your pharmacist whether stomach protection or a different pain option would suit you.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Apixaban and Proquazone together?
Using apixaban with proquazone can add up to a higher bleeding risk, so keep taking both as prescribed, watch for signs of bleeding, and flag this combination before any spinal procedure or surgery. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Proquazone 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 Proquazone interaction managed?
Your care team can keep this combination safe by tailoring your plan and watching you more closely. Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Watch for bleeding: unusual bruising, nosebleeds, pink or red urine, black or bloody stools, or bleeding that will not stop. Report these right away. Before any spinal or epidural procedure or surgery, tell the team… 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 Proquazone 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 Proquazone
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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