Aspirin and Apixaban Interaction
Drug interaction information between Aspirin and Apixaban.
Aspirin and Apixaban have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Aspirin and Apixaban. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Aspirin and apixaban both thin the blood, and taking them together can nearly double your risk of having a bleeding event. This happens because both drugs make it harder for your blood to clot.
What To Do
Your doctor should monitor you closely for bleeding while you are on both medications. Do not start or stop taking aspirin without first consulting your healthcare provider.
FDA Label Information
7.3 Anticoagulants and Antiplatelet Agents Coadministration of antiplatelet agents, fibrinolytics, heparin, aspirin, and chronic NSAID use increases the risk of bleeding. APPRAISE-2, a placebo-controlled clinical trial of apixaban in high-risk, post-acute coronary syndrome patients treated with aspirin or the combination of aspirin and clopidogrel, was terminated early due to a higher rate of bleeding with apixaban compared to placebo. In ARISTOTLE, concomitant use of aspirin increased the bleeding risk on apixaban from 1.8% per year to 3.4% per year and concomitant use of aspirin and...
Aspirin Also Interacts With
- Atenolol major
- Fluoxetine major
- Ibandronate major
- Alendronate moderate
- Desvenlafaxine moderate
Apixaban Also Interacts With
- Clopidogrel moderate
- Warfarin moderate
- Carbamazepine moderate
- Rifampin moderate
- Heparin moderate
Frequently Asked Questions
Can I take Aspirin and Apixaban together?
This is a moderate interaction. Your doctor should monitor you closely for bleeding while you are on both medications. Do not start or stop taking aspirin without first consulting your healthcare provider.
How serious is the interaction between Aspirin and Apixaban?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Aspirin and Apixaban interact?
Aspirin and apixaban both thin the blood, and taking them together can nearly double your risk of having a bleeding event. This happens because both drugs make it harder for your blood to clot.
Understanding the Aspirin and Apixaban Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Aspirin belongs to the Antiplatelet / NSAID class and Apixaban belongs to the Direct Oral Anticoagulant (Factor Xa Inhibitor) class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Aspirin and apixaban both thin the blood, and taking them together can nearly double your risk of having a bleeding event. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Aspirin has 47 total documented interactions on file in this dataset, and Apixaban has 12. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should monitor you closely for bleeding while you are on both medications. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Aspirin or Apixaban based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.