Apixaban and Relacorilant: 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
Relacorilant
Apixaban
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.
Here's what's going on. Apixaban (Eliquis) is a blood thinner. Your body clears it partly using a liver enzyme called CYP3A4. Relacorilant slows that enzyme down. When the enzyme is slowed, apixaban can build up in your blood, and more blood thinner means a higher chance of bleeding, like easy bruising, nosebleeds, or bleeding that is hard to stop.
The good news: this is a well-known, manageable situation. Please don't stop either medicine on your own. Talk with your pharmacist or doctor. They can decide whether these two should be used together and watch you closely for any signs of bleeding.
Mechanism: Relacorilant inhibits CYP3A4, reducing metabolism of the CYP3A4 substrate apixaban. Apixaban is an active drug (not a prodrug), so inhibition raises its exposure.
- Direction: Increased apixaban AUC/Cmax, increasing bleeding risk.
- Severity/evidence: Major; probable. Onset unspecified.
- Note: Apixaban is also a P-gp substrate; combined pathway inhibition can compound exposure.
- Management: Per labeling, avoid concomitant use unless otherwise recommended. If co-administered, individualize dosing and monitor closely for bleeding (signs/symptoms, Hgb/Hct as clinically indicated).
What happens
Increased CYP3A4 substrate exposure and an increased risk of CYP3A4-substrate-related adverse reactions
Interaction Deep Dive
Do not combine relacorilant with CYP3A4 substrates unless there is a specific recommendation to do so. Taking them together can raise the exposure to these substrates and heighten the likelihood of adverse reactions associated with them1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of relacorilant
How to manage this interaction
What your care team may do:
- Review whether these two drugs should be used together at all, since the label advises avoiding this combination unless specifically recommended.
- If they decide you need both, the plan can be individualized by your team, and they may monitor you more closely for bleeding.
What you can do:
- Keep taking both exactly as prescribed until your pharmacist or prescriber tells you otherwise.
- Report unusual bruising, nosebleeds, pink or red urine, black stools, or bleeding that won't stop.
- Ask your pharmacist before adding any new medicine or supplement.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In drug interaction studies, giving relacorilant at 350 mg in the fasted state (1.8 times the relacorilant exposure achieved at the recommended dose) once daily for 10 days together with midazolam (a CYP3A4 substrate) raised the Cmax by 3.1-fold and the AUC by 8.9-fold 1.
Common questions
Can I take Apixaban and Relacorilant together?
Relacorilant can raise apixaban levels and increase bleeding risk, so this combination is generally avoided unless your care team specifically recommends it. Don't change anything on your own, and report any signs of bleeding. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Apixaban and Relacorilant 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 Relacorilant interaction managed?
What your care team may do: Review whether these two drugs should be used together at all, since the label advises avoiding this combination unless specifically recommended. If they decide you need both, the plan can be individualized by your team, and they may monitor you more closely for bleeding. What you can do: Keep taking both exactly as prescribed until your pharmacist or prescriber tells y… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
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 Relacorilant 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 (1)
- Product Information: LIFYORLI™ oral capsules, relacorilant oral capsules. Corcept Therapeutics Incorporated (Per Manufacturer), Redwood City, CA, 2026. DailyMed
Keep reading about Relacorilant
Keep reading about Apixaban
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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