Vimseltinib 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
Vimseltinib
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. Vimseltinib (Romvimza) can block a transporter in your body called P-gp that normally helps push apixaban out. When that transporter is slowed down, more apixaban can build up in your blood.
More apixaban means a higher chance of bleeding, like easy bruising, nosebleeds, or bleeding that is hard to stop. This is worth taking seriously, but the good news is your care team can manage it, often by spacing the doses apart or adjusting your plan. Please don't stop either medicine on your own. Just talk with your pharmacist or doctor.
Mechanism: Vimseltinib inhibits P-glycoprotein (P-gp)-mediated efflux. Apixaban is a P-gp substrate, so co-administration can increase apixaban exposure (AUC/Cmax).
Direction/effect: Increased apixaban exposure raises bleeding risk. Neither agent is a prodrug here, so the effect is a straightforward exposure increase.
- Severity: Major; evidence: probable; onset: unspecified.
- Management: Avoid concomitant use if possible. If unavoidable, administer vimseltinib at least 4 hours before apixaban. Monitor for signs of bleeding; apixaban dose may need to be individualized by the care team.
What happens
Increased risk of P-gp substrate exposure
Interaction Deep Dive
Because vimseltinib can raise the exposure of P-gp substrates, using the two together should be avoided. When such combined use is unavoidable, administer vimseltinib no less than 4 hours before the P-gp substrates1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport by vimseltinib
How to manage this interaction
What your care team may do:
- Try to avoid using these two together when possible.
- If both are needed, take vimseltinib at least 4 hours before your apixaban dose to help reduce the interaction.
- Watch you more closely for bleeding, and your apixaban dose may be adjusted and individualized by your team.
What you should do: Keep taking both exactly as prescribed unless your provider tells you otherwise. Report any unusual bruising, nosebleeds, blood in urine or stool, or bleeding that won't stop. Ask your pharmacist or prescriber before making any changes.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a drug interaction study, dabigatran (a P-gp substrate) is projected to have its AUC (0 to inf) and Cmax rise by 2- to 3-fold when taken together with vimseltinib 30 mg twice weekly. When dabigatran is given 4 hours after vimseltinib 30 mg twice weekly, its Cmax and AUC (0 to inf) are projected to rise by as much as 1.3-fold 1.
Common questions
Can I take Vimseltinib and Apixaban together?
Vimseltinib can raise apixaban levels and increase bleeding risk; avoid combining if possible, and if you must use both, take vimseltinib at least 4 hours before apixaban and watch closely for bleeding. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Vimseltinib 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 Vimseltinib and Apixaban interaction managed?
What your care team may do: Try to avoid using these two together when possible. If both are needed, take vimseltinib at least 4 hours before your apixaban dose to help reduce the interaction. Watch you more closely for bleeding, and your apixaban dose may be adjusted and individualized by your team. What you should do: Keep taking both exactly as prescribed unless your provider tells you otherwis… 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 Vimseltinib 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 (1)
- Product Information: ROMVIMZA(TM) oral capsules, vimseltinib oral capsules. Deciphera Pharmaceuticals, LLC (per FDA), Waltham, MA, 2025. DailyMed
Keep reading about Apixaban
Keep reading about Vimseltinib
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