What the FDA labels say about taking them together
Apixaban and heparin
Apixaban's FDA label of April 24, 2026 names heparin in its drug interactions section, and heparin's label names apixaban too. The heparin label: “Avoid use of heparin after use of andexanet alfa for the reversal of direct Factor Xa inhibitors (apixaban and rivaroxaban).”
Check it at the source: the apixaban FDA label on DailyMed (effective April 24, 2026, Cardinal Health 107, LLC); the heparin FDA label on DailyMed (effective November 28, 2025, Fresenius Kabi USA, LLC).
What does the apixaban label say about heparin?
Apixaban label, drug interactionsCoadministration of antiplatelet agents, fibrinolytics, heparin, aspirin, and chronic NSAID use increases the risk of bleeding.
Apixaban label, warnings and precautionsThese include aspirin and other antiplatelet agents, other anticoagulants, heparin, thrombolytic agents, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs) [see Drug Interactions (7.3) ].
Source: FDA drug label (ELIQUIS), NDA202155 (Bristol Myers Squibb), as published by Cardinal Health 107, LLC, effective April 24, 2026 (SPL set a454cd24-0c6d-46e8-b1e4-197388606175), via openFDA; the full label on DailyMed
What does the heparin label say about apixaban?
Heparin Sodium label (Hospira, Inc., May 12, 2026), drug interactionsAvoid use of heparin after use of andexanet alfa for the reversal of direct Factor Xa inhibitors (apixaban and rivaroxaban).
Heparin Sodium label (Hospira, Inc., May 12, 2026), warnings and precautionsHeparin with Concomitant Use With Andexanet Alfa Unresponsiveness to unfractionated heparin leading to non-prolongation of activated clotting times and serious thrombotic events has occurred when unfractionated heparin was administered after use of andexanet alfa for the reversal of direct Factor Xa inhibitors (apixaban and rivaroxaban).
Source: FDA drug label (Heparin Sodium, NDA018916), Hospira, Inc., effective May 12, 2026 (SPL set 0413f511-6b34-4c15-e48b-3fad08baacbe), via openFDA
Source: FDA drug label (Heparin Sodium), Fresenius Kabi USA, LLC, effective November 28, 2025 (SPL set d55b4a63-0c04-4874-b74f-9e9b9e8b008c), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Apixaban | Heparin | |
|---|---|---|
| Labeled for | Atrial fibrillation, Blood clots (DVT and PE), Stroke prevention | Blood clots (DVT and PE), Atrial fibrillation |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $5.52 per tablet 5 mg tablet | $1.18 per mL 5,000 unit/mL vial |
| Shortage now | No current entry | In shortage |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once