Paritaprevir 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
Paritaprevir
No brand names on recordApixaban
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.
These two medicines can interact. Apixaban (Eliquis) is a blood thinner that helps prevent clots. Paritaprevir can slow down the liver enzyme (called CYP3A) that normally breaks apixaban down. When that clearing slows, more apixaban can build up in your body.
More apixaban means a stronger blood-thinning effect, which can raise your risk of bleeding, such as easy bruising, nosebleeds, or bleeding that is hard to stop. The good news is that your care team can manage this by watching you closely and tailoring your doses. Please don't stop or change either medicine on your own, just check in with your pharmacist or doctor.
Effect: Increased apixaban exposure. Paritaprevir inhibits CYP3A, a primary metabolic pathway for apixaban (a CYP3A/P-gp substrate), reducing clearance and raising AUC/Cmax with increased bleeding risk.
- Direction: Increased apixaban effect (PK inhibition). Neither agent is a prodrug requiring activation.
- Magnitude: Potentially significant; not precisely quantified.
- Onset: Unspecified.
- Evidence: Theoretical.
- Management: No specific manufacturer guidance for strong CYP3A inhibitors lacking P-gp activity; guidelines suggest avoiding coadministration or using cautiously with close clinical monitoring for bleeding. Dose may need individualization by the care team.
What happens
Increased apixaban exposure
Interaction Deep Dive
When apixaban (a CYP3A substrate) is taken together with a potent CYP3A inhibitor, apixaban concentrations may rise considerably2. Although the manufacturer offers no specific recommendations regarding the combined use of apixaban with strong CYP3A inhibitors that do not additionally inhibit P-gp 1, clinical guidelines recommend either avoiding the combination or using it with caution alongside close monitoring 2.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism of apixaban
How to manage this interaction
What your care team may do:
- Consider whether the two drugs should be used together, or use them cautiously with closer monitoring.
- Watch you more closely for signs of bleeding, since apixaban levels may rise.
- Individualize your apixaban dose if needed.
What you can do:
- Keep taking both medicines exactly as prescribed unless told otherwise.
- Tell your pharmacist or doctor about unusual bruising, bleeding that won't stop, blood in urine or stool, or black stools.
- Ask your pharmacist before adding any new medicine or supplement.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Paritaprevir and Apixaban together?
Paritaprevir can raise apixaban levels and increase bleeding risk, so your care team may avoid the combination or monitor you closely. Keep taking both as prescribed and report any unusual bleeding to your pharmacist or doctor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Paritaprevir 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 Paritaprevir and Apixaban interaction managed?
What your care team may do: Consider whether the two drugs should be used together, or use them cautiously with closer monitoring. Watch you more closely for signs of bleeding, since apixaban levels may rise. Individualize your apixaban dose if needed. What you can do: Keep taking both medicines exactly as prescribed unless told otherwise. Tell your pharmacist or doctor about unusual bruising, ble… 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 Paritaprevir 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 (2)
- Product Information: ELIQUIS(R) oral film coated tablets, apixaban oral film coated tablets. Bristol-Myers Squibb Company (per Dailymed), Princeton, NJ, 2024. DailyMed
- Steffel J, Collins R, Antz M, et al: 2021 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Europace 2021; 23(10):1612-1676.
Keep reading about Paritaprevir
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist