Clopidogrel and Apixaban Interaction
Drug interaction information between Clopidogrel and Apixaban.
Clopidogrel and Apixaban have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Clopidogrel 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
Both of these medicines prevent blood clots in different ways, and using them together significantly increases your risk of serious bleeding. Clinical trials were even stopped early because this combination caused too much bleeding.
What To Do
Use this combination only if specifically directed by your doctor and watch for any signs of unusual bruising or bleeding. Your healthcare provider should monitor you very closely.
FDA Label Information
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.
Clopidogrel Also Interacts With
- Omeprazole moderate
- Warfarin moderate
- Esomeprazole moderate
- Rifampin moderate
- Norepinephrine moderate
Apixaban Also Interacts With
- Aspirin moderate
- Warfarin moderate
- Carbamazepine moderate
- Rifampin moderate
- Heparin moderate
Frequently Asked Questions
Can I take Clopidogrel and Apixaban together?
This is a moderate interaction. Use this combination only if specifically directed by your doctor and watch for any signs of unusual bruising or bleeding. Your healthcare provider should monitor you very closely.
How serious is the interaction between Clopidogrel 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 Clopidogrel and Apixaban interact?
Both of these medicines prevent blood clots in different ways, and using them together significantly increases your risk of serious bleeding. Clinical trials were even stopped early because this combination caused too much bleeding.
Understanding the Clopidogrel and Apixaban Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Clopidogrel belongs to the Antiplatelet Agent 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: Both of these medicines prevent blood clots in different ways, and using them together significantly increases your risk of serious bleeding. 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. Clopidogrel has 19 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: Use this combination only if specifically directed by your doctor and watch for any signs of unusual bruising or bleeding. 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 Clopidogrel 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.