Proglumetacin 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
Proglumetacin
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 proglumetacin is an anti-inflammatory pain reliever (an NSAID). Taken together, they can both make it harder for your blood to clot. That means a higher chance of bleeding, such as easy bruising, nosebleeds, stomach bleeding, or bleeding that is slow to stop.
The good news is that this is manageable. Your care team can watch you more closely and adjust your treatment if needed. Please don't stop either medicine on your own. Just let your pharmacist or doctor know you take both, and tell them right away if you notice unusual bleeding, black or bloody stools, pink urine, or a bad headache.
Effect: Additive risk of serious bleeding when combining apixaban (factor Xa inhibitor) with proglumetacin (an NSAID).
Mechanism: Pharmacodynamic additive effect on hemostasis. Apixaban impairs coagulation; NSAIDs impair platelet function and can cause GI mucosal injury. Neither is a prodrug relevant here; direction is increased bleeding risk.
- Severity: Major; evidence: theoretical; onset: unspecified
- High-risk setting: neuraxial anesthesia/spinal puncture (risk of epidural/spinal hematoma, possible paralysis)
- Management: Monitor for bleeding (Hgb/Hct, signs of GI or intracranial bleed); consider gastroprotection; dose and therapy individualized by the care team; use an alternative analgesic where feasible.
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 paralysis5. When these drugs are given concurrently, watch for signs of bleeding124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
If both are prescribed, the priority is watching for bleeding, not panicking. Your care team can manage this by monitoring you more closely and tailoring your treatment.
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Ask whether a different pain reliever (one that is not an NSAID) might be an option for you.
- Watch for and report unusual bruising, nosebleeds, black or bloody stools, pink or red urine, vomiting blood, or a severe headache.
- If you are scheduled for any spinal procedure or spinal/epidural anesthesia, tell that team you take both drugs, since this raises the risk of a dangerous spinal bleed.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Proglumetacin and Apixaban together?
Combining Eliquis (apixaban) with the NSAID proglumetacin raises bleeding risk, so keep both only under your care team's guidance, watch for signs of bleeding, and flag any upcoming spinal procedures. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Proglumetacin 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 Proglumetacin and Apixaban interaction managed?
If both are prescribed, the priority is watching for bleeding, not panicking. Your care team can manage this by monitoring you more closely and tailoring your treatment. Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Ask whether a different pain reliever (one that is not an NSAID) might be an option for you. Watch for and report unusual bruising, nosebleeds, b… 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 Proglumetacin 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 Proglumetacin
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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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