Apixaban and Ketoconazole Interaction
Drug interaction information between Apixaban and Ketoconazole.
Apixaban and Ketoconazole have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Apixaban and Ketoconazole. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Ketoconazole blocks the enzymes and proteins that normally clear apixaban from your body. This can cause the level of apixaban in your blood to rise too high.
FDA Label Information
( 7.2 , 12.3 ) 7.1 Combined P-gp Strong CYP3A4 Inhibitors For patients receiving apixaban 5 mg or 10 mg twice daily, the dose of apixaban should be decreased by 50% when coadministered with drugs that are combined P-gp and strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir) [see Dosage and Administration (2.5) and Clinical Pharmacology ( 12.3) ].
Apixaban Also Interacts With
- Clopidogrel moderate
- Aspirin moderate
- Warfarin moderate
- Carbamazepine moderate
- Rifampin moderate
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Frequently Asked Questions
What SPL severity band is on file for Apixaban + Ketoconazole?
Compiled FDA labeling labels this pair minor. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Ketoconazole has 113 labeled pairs on file vs Apixaban's 12. In the minor band specifically: Apixaban has 3 (also Clarithromycin, Itraconazole); Ketoconazole has 85 (also Abiraterone, Acetaminophen/Oxycodone, Alosetron, Amphotericin B).
What mechanism field is on file for Apixaban and Ketoconazole?
Ketoconazole blocks the enzymes and proteins that normally clear apixaban from your body. This can cause the level of apixaban in your blood to rise too high.
Ketoconazole carries more major-labeled pairs than Apixaban
SPL source-record counts only. This page's band is minor · classes on file: Apixaban (Direct Oral Anticoagulant (Factor Xa Inhibitor)); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Apixaban's 0. This page itself is in the minor band, not the major band.
0 major · 9 moderate · 3 minor · 12 total
- Other minor peers for Apixaban
- Clarithromycin
- Itraconazole
6 major · 22 moderate · 85 minor · 113 total
- Other minor peers for Ketoconazole
- Abiraterone
- Acetaminophen/Oxycodone
- Alosetron
- Amphotericin B
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.