Propyphenazone 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
Propyphenazone
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 propyphenazone is a pain and fever reliever in the NSAID family. When you take them together, both can make it a little harder for your blood to clot. That means the two effects can add up and raise your chance of bleeding, like easy bruising, nosebleeds, or bleeding that is harder to stop.
The good news is this is something your care team handles all the time. Please don't stop either medicine on your own. Do let your pharmacist or doctor know you take both, and watch for unusual bruising, blood in your stool or urine, or bleeding that won't quit.
Mechanism: additive pharmacodynamic effect on hemostasis. Apixaban is a direct factor Xa inhibitor; propyphenazone is an NSAID with antiplatelet and GI mucosal effects. Neither is a prodrug here, so the effect is additive bleeding risk, not a PK change.
- Direction: increased bleeding risk versus either agent alone.
- Evidence: theoretical; severity rated major.
- Onset: unspecified.
- Management: monitor for signs/symptoms of bleeding (GI bleed, hematuria, bruising, drop in Hgb/Hct). Heightened caution with neuraxial anesthesia or spinal puncture given epidural/spinal hematoma risk. Dose and need for continued NSAID may be individualized by the care team.
What happens
An increased risk of bleeding
Interaction Deep Dive
Using an anticoagulant together with an NSAID can raise the likelihood of serious bleeding compared with taking either agent by itself1234, and in patients undergoing neuraxial anesthesia or spinal puncture it can heighten the risk of epidural or spinal hematomas, which may cause long-term or permanent paralysis 5. When the two are given together, watch for signs of bleeding 124.
Why it happens (mechanism)
Additive effect on hemostasis
How to manage this interaction
If both are prescribed, keep taking them as directed unless your prescriber tells you otherwise. Your care team can manage this safely.
- Your team may monitor you more closely for bleeding, and your medications may be adjusted and individualized to fit your needs.
- Watch for warning signs: unusual bruising, nosebleeds, black or bloody stools, pink or red urine, coughing or vomiting blood, or bleeding that won't stop.
- Tell any provider you take both drugs, especially before a spinal or epidural procedure, because of a rare risk of spinal bleeding.
- Ask your pharmacist before adding any new pain reliever.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Propyphenazone and Apixaban together?
Taking apixaban with propyphenazone can add up to a higher bleeding risk, so keep both as prescribed but watch for bleeding and let your pharmacist or doctor know you take both, especially before any spinal procedure. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Propyphenazone 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 Propyphenazone and Apixaban interaction managed?
If both are prescribed, keep taking them as directed unless your prescriber tells you otherwise. Your care team can manage this safely. Your team may monitor you more closely for bleeding, and your medications may be adjusted and individualized to fit your needs. Watch for warning signs: unusual bruising, nosebleeds, black or bloody stools, pink or red urine, coughing or vomiting blood, or bleedin… 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 Propyphenazone 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 Propyphenazone
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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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