Clonixin and Apixaban: 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
Clonixin
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. Clonixin is a pain reliever in the NSAID family (like ibuprofen or naproxen). Both of these can make it harder for your blood to clot, so taking them together can add up and raise your chance of bleeding, such as easy bruising, nosebleeds, or bleeding in the stomach.
This is based mostly on how these medicines work rather than large studies, but it's still worth taking seriously. The good news is your care team can manage this. Keep taking both exactly as prescribed, and let your pharmacist or doctor know if you notice unusual bleeding or bruising.
Effect: Additive bleeding risk from combining a factor Xa inhibitor (apixaban) with an NSAID (clonixin). Neither drug is a prodrug; this is a pharmacodynamic (PD), not pharmacokinetic, interaction.
- Mechanism: Additive effects on hemostasis (anticoagulant plus NSAID-mediated platelet inhibition and GI mucosal injury).
- Severity/Evidence: Major, but theoretical basis; onset unspecified.
- Special risk: Elevated risk of spinal/epidural hematoma with neuraxial anesthesia or spinal puncture.
- Management: Monitor for signs/symptoms of bleeding (including GI); consider gastroprotection and reassessing NSAID necessity. Individualize per clinical judgment.
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 in patients receiving neuraxial anesthesia or undergoing spinal puncture it can heighten the risk of epidural or spinal hematomas, which may lead to long-term or permanent paralysis 5. When the two are given at the same time, watch for signs of bleeding 124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
Your care team can manage this combination safely with a few precautions.
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Your team may monitor you more closely for bleeding, and your treatment may be adjusted and individualized to fit your needs.
- Watch for warning signs: unusual bruising, nosebleeds, pink or red urine, black or bloody stools, or vomit that looks like coffee grounds.
- Tell any provider you take both drugs before any spinal procedure or epidural, since this raises the risk of spinal bleeding.
Report any bleeding symptoms to your pharmacist or doctor promptly.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clonixin and Apixaban together?
Apixaban and clonixin (an NSAID) both increase bleeding risk, so together they can add up; keep taking both as prescribed, watch for any signs of bleeding, and check with your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clonixin and Apixaban 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 Clonixin and Apixaban interaction managed?
Your care team can manage this combination safely with a few precautions. Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Your team may monitor you more closely for bleeding, and your treatment may be adjusted and individualized to fit your needs. Watch for warning signs: unusual bruising, nosebleeds, pink or red urine, black or bloody stools, or vomit that loo… 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 Clonixin or Apixaban 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 Clonixin
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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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