Drug & supplement interaction

K2/spice + Apixaban

Apixaban brand name: Eliquis.

No Known Interaction
The bottom line No known interaction

We found no known interaction between K2/spice and Apixaban in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

K2/spice and Apixaban

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Apixaban and K2/spice in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

K2/spice safety at a glance

K2/spice overall Avoid These products are illegal, unregulated, and have caused serious harm and death.
Pregnancy Avoid Never use during pregnancy; it can seriously harm both mother and baby.
Breastfeeding Avoid Avoid while breastfeeding; chemicals can pass to the infant and cause harm.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Apixaban and K2/spice? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Apixaban

Interactions in our licensed database are recorded against drug classes, not just single drug names. Apixaban is filed under 4 classifications — including anticoagulant/antiplatelet drugs, p-glycoprotein substrates, cytochrome p450 3a4 (cyp3a4) substrates. K2/spice has documented interactions with 2 drug classes — the most serious being anticonvulsants (moderate) and qt interval-prolonging drugs (moderate) — and none of Apixaban’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

K2/spice Does Interact With Other Medications

K2/spice has 208 moderate known drug interactions in our database — Apixaban isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against K2/spice

Covers the 2,830 medications we’ve checked against K2/spice. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests K2/spice and Apixaban May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • An irregular heartbeat Worth acting on Additional detail

    K2/spice

    “When inhaled, K2/spice can cause serious adverse cardiovascular effects, including tachycardia or bradycardia, hypertension or hypotension, coronary vasospasm, acute coronary syndrome, congestive heart failure, ventricular fibrillation, QT prolongation, myocardial ischemia/infarction, stroke, cardiac arrest, cardiomyopathy, and sudden cardiac death.”

    K2/spice · Natural Medicines adverse-effect record, reported in arrhythmia.

    6 sources cited
    1. 98843. Andonian DO, Seaman SR, Josephson EB. Profound hypotension and bradycardia in the setting of synthetic cannabinoid intoxication - a case series. Am J Emerg Med 2017;35(6):940.e5-940.e6. PubMed
    2. 98844. McIlroy G, Ford L, Khan JM. Acute myocardial infarction, associated with the use of a synthetic adamantyl-cannabinoid: a case report. BMC Pharmacol Toxicol 2016;17:2. PubMed
    3. 98846. Clark BC, Georgekutty J, Berul CI. Myocardial ischemia secondary to synthetic cannabinoid (K2) use in pediatric patients. J Pediatr 2015;167(3):757-61.e1. PubMed
    4. 98849. Freeman MJ, Rose DZ, Myers MA, Gooch CL, Bozeman AC, Burgin WS. Ischemic stroke after use of the synthetic marijuana "spice". Neurology 2013;81(24):2090-3. PubMed
    5. 99617. Law R, Schier J, Martin C, Chang A, Wolkin A; Centers for Disease Control (CDC). Notes from the field: increase in reported adverse health effects related to synthetic cannabinoid use - United States, January-May 2015. MMWR Morb Mortal Wkly Rep 2015;64(22
    6. 99619. Monte AA, Calello DP, Gerona RR, et al. Characteristics and treatment of patients with clinical illness due to synthetic cannabinoid inhalation reported by medical toxicologists: a ToxIC database study. J Med Toxicol 2017;13(2):146-52. PubMed

    Apixaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Apixaban. Read the label on DailyMed ›

  • Bleeding or bruising Worth acting on Additional detail

    K2/spice

    “When inhaled long-term, K2/spice has been associated with immune thrombocytopenia. In one case, a 23-year-old male with a one-year history of K2/spice abuse presented with epistaxis and petechial rashes on both legs. Laboratory testing confirmed a diagnosis of immune thrombocytopenia, and the patient was successfully treated with prednisolone.”

    K2/spice · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    1 source cited
    1. 99620. Öztürk E, Oral A, Özdemir M, Bambul N. Synthetic marijuana "K2" induced ITP. Platelets 2015;26(3):258-9. PubMed

    “When inhaled, K2/spice has been linked to hematologic complications. An outbreak of synthetic cannabinoid-associated coagulopathy was reported in Illinois in 2018. Anticoagulant testing in 15 patients with suspected synthetic cannabinoid-associated coagulopathy suggested that K2/spice contaminated with brodifacoum, a 4-hydroxycoumarin derivative was to blame.”

    K2/spice · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    5 sources cited
    1. 98850. Kelkar AH, Smith NA, Martial A, Moole H, Tarantino MD, Roberts JC. An outbreak of synthetic cannabinoid-associated coagulopathy in Illinois. N Engl J Med 2018;379(13):1216-23. PubMed
    2. 99620. Öztürk E, Oral A, Özdemir M, Bambul N. Synthetic marijuana "K2" induced ITP. Platelets 2015;26(3):258-9. PubMed
    3. 99626. Zheng CY, Minniti CP, Chaitowitz MH. Sickle cell crisis complicated by synthetic cannabinoid abuse: a case report. Hemoglobin 2016;40(3):220-2. PubMed
    4. 111236. D'Errico S, Zanon M, Radaelli D, et al. Acute Kidney Injury (AKI) in Young Synthetic Cannabinoids Abusers. Biomedicines 2022;10(8):1936. PubMed
    5. 104901. Godwin PO, Unterman S, Elfessi ZZ, Bhagat JD, Kolman K. Management of Rodenticide Poisoning Associated with Synthetic Cannabinoids. Fed Pract. 2019;36(5):237-241.

    Apixaban

    Listed in the ADVERSE REACTIONS section of the FDA label for Apixaban. Read the label on DailyMed ›

Reported for K2/spice but not commonly for Apixaban: heart failure, confusion, a heart attack and memory problems.

Effects for Apixaban come from the ADVERSE REACTIONS section of its FDA label; effects for K2/spice come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About K2/spice or Apixaban

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers K2/spice or Apixaban, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Apixaban

This page covers K2/spice only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Apixaban page lists 285 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Grapefruit (major), Piracetam (major) and St. John's Wort (major).

By severity: 5 major · 240 moderate · 40 minor.

From our pharmacist’s overview on the Apixaban page

“St. John's wort can weaken apixaban (Eliquis), speeding how the body clears this blood thinner and leaving you less protected from the strokes and clots it is prescribed to prevent.”

Reviewed by 2 · Jul 18, 2026

Open the Apixaban interaction page

How much people look this up

Where K2/spice and Apixaban Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement K2/spice
Steady interest

#1,325 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Apixaban
Most looked up

#1 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every K2/spice reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The K2/spice and Apixaban records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About K2/spice

What is K2/spice?

  • Recreational drug ('legal high')
  • Marijuana substitute
  • Mood or perception changes
  • Sometimes used to avoid drug testing

K2/Spice is NOT a herbal supplement — it is plant material sprayed with man-made synthetic cannabinoid chemicals. It is dangerous, unpredictable, and has caused seizures, heart problems, psychosis, and deaths, so it should not be used.

Not a plant part; synthetic chemicals sprayed onto dried plant material · Dried plant material that is smoked or vaped; sometimes sold as liquid for vaping

An interaction check asks whether these two react with each other — it does not ask whether K2/spice is a good idea for someone in your situation. Here is what our K2/spice record says about it on its own.

K2/spice: dosing

There is no safe or recommended dose of K2/Spice. Because these are unregulated, illegal products with unknown and constantly changing ingredients, no dose can be considered safe. The strength can vary wildly even within a single package.This is not a supplement that should be taken at any amount. If you are looking for help with substance use, please reach out to a healthcare provider, pharmacist, or a substance-use support service.

From our K2/spice monograph — the full record covers uses, side effects and every documented interaction.

Read the full K2/spice monograph & all interactions
Medication

About Apixaban

What Is Apixaban Used For?

Brand name: Eliquis

Apixaban is used to reduce the risk of stroke and dangerous clots traveling through the body in adults with nonvalvular atrial fibrillation (an irregular heart rhythm not caused by a heart valve problem). It is also used to prevent deep vein thrombosis (DVT — a blood clot in the leg) in adults after hip or knee replacement surgery, and to treat DVT and pulmonary embolism (PE — a blood clot in the lungs) in adults, including reducing the risk of those clots coming back.

Eliquis (the brand-name tablet and kit) is additionally approved to treat venous thromboembolism (VTE — blood clots in the veins) and reduce the risk of recurrent VTE in pediatric patients from birth and older, after at least 5 days of initial anticoagulant treatment. The generic apixaban tablet carries the adult indications only.

See full Apixaban drug information
Keep checking

Other Drugs & K2/spice

Browse every other medication we’ve checked against K2/spice — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
208Moderate
0Minor
2,621No known interaction
Moderate

208 interactions

Showing 60 of 208 moderate interactions — see all 208 on the K2/spice page.

No interaction 2,621 drugs checked — show the list
Evidence & sources

K2/spice References

The 40 references that drive our K2/spice monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Amar JY, Ruta J, Rahimian D, Dillinger RL, Katz P. Toxic leukoencephalopathy with extrapyramidal dysfunction due to synthetic cannabinoids. J Clin Neurosci 2018;58:213-4. PubMed
  2. Andonian DO, Seaman SR, Josephson EB. Profound hypotension and bradycardia in the setting of synthetic cannabinoid intoxication - a case series. Am J Emerg Med 2017;35(6):940.e5-940.e6. PubMed
  3. McIlroy G, Ford L, Khan JM. Acute myocardial infarction, associated with the use of a synthetic adamantyl-cannabinoid: a case report. BMC Pharmacol Toxicol 2016;17:2. PubMed
  4. Chinnadurai T, Shrestha S, Ayinla R. A curious case of inhalation fever caused by synthetic cannabinoid. Am J Case Rep 2016;17:379-83. PubMed
  5. Clark BC, Georgekutty J, Berul CI. Myocardial ischemia secondary to synthetic cannabinoid (K2) use in pediatric patients. J Pediatr 2015;167(3):757-61.e1. PubMed
  6. Davidson C, Opacka-Juffry J, Arevalo-Martin A, Garcia-Ovejero D, Molina-Holgado E, Molina-Holgado F. Spicing up pharmacology: a review of synthetic cannabinoids from structure to adverse events. Adv Pharmacol 2017;80:135-68. PubMed
  7. Durand D, Delgado LL, de la Parra-Pellot DM, Nichols-Vinueza D. Psychosis and severe rhabdomyolysis associated with synthetic cannabinoid use: a case report. Clin Schizophr Relat Psychoses 2015;8(4):205-8. DOI
  8. Freeman MJ, Rose DZ, Myers MA, Gooch CL, Bozeman AC, Burgin WS. Ischemic stroke after use of the synthetic marijuana "spice". Neurology 2013;81(24):2090-3. PubMed
  9. Kelkar AH, Smith NA, Martial A, Moole H, Tarantino MD, Roberts JC. An outbreak of synthetic cannabinoid-associated coagulopathy in Illinois. N Engl J Med 2018;379(13):1216-23. PubMed
  10. Lamy FR, Daniulaityte R, Nahhas RW, et al. Increases in synthetic cannabinoids-related harms: results from a longitudinal web-based content analysis. Int J Drug Policy. 2017;44:121-9. PubMed
  11. Law R, Schier J, Martin C, Chang A, Wolkin A; Centers for Disease Control (CDC). Notes from the field: increase in reported adverse health effects related to synthetic cannabinoid use - United States, January-May 2015. MMWR Morb Mortal Wkly Rep 2015;64(22
  12. Castaneto MS, Gorelick DA, Desrosiers NA, Hartman RL, Pirard S, Huestis MA. Synthetic cannabinoids: epidemiology, pharmacodynamics, and clinical implications. Drug Alcohol Depend 2014;144:12-41. PubMed
  13. Monte AA, Calello DP, Gerona RR, et al. Characteristics and treatment of patients with clinical illness due to synthetic cannabinoid inhalation reported by medical toxicologists: a ToxIC database study. J Med Toxicol 2017;13(2):146-52. PubMed
  14. Öztürk E, Oral A, Özdemir M, Bambul N. Synthetic marijuana "K2" induced ITP. Platelets 2015;26(3):258-9. PubMed
  15. Schwartz MD, Trecki J, Edison LA, Steck AR, Arnold JK, Gerona RR. A common source outbreak of severe delirium associated with exposure to the novel synthetic cannabinoid ADB-PINACA. J Emerg Med 2015;48(5):573-80. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking K2/spice and Apixaban Together: Common Questions

Is it safe to take K2/spice with Apixaban?
We do not list a known interaction between K2/spice and Apixaban. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do K2/spice and Apixaban have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the K2/spice and Apixaban combination checked?
Interactions in our licensed database are recorded against drug classes. Apixaban is filed under 4 classifications, and K2/spice has documented interactions with 2 drug classes — none of Apixaban's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does K2/spice interact with any other medications?
Yes. K2/spice has 208 documented drug interactions in our database — Apixaban is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Apixaban interact with any supplements?
Yes. Apixaban has documented interactions with 285 supplements in our database — K2/spice is not one of them. The Apixaban interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Apixaban and K2/spice?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.