Nirmatrelvir/Ritonavir and Apixaban Interaction
Drug interaction information between Nirmatrelvir/Ritonavir and Apixaban.
Nirmatrelvir/Ritonavir and Apixaban have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Nirmatrelvir/Ritonavir and Apixaban. 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
Paxlovid blocks the enzymes and proteins that normally clear apixaban from your body, causing the blood thinner to build up. This increases your risk of serious bleeding.
FDA Label Information
apixaban ↑ apixaban Combined P-gp and strong CYP3A inhibitors increase blood levels of apixaban and increase the risk of bleeding. Dosing recommendations for co-administration of apixaban with PAXLOVID depend on the apixaban dose. Refer to the apixaban product label for more information.
Nirmatrelvir/Ritonavir Also Interacts With
- Simvastatin major
- Lovastatin major
- Sildenafil major
- Carbamazepine major
- Rifampin major
Apixaban Also Interacts With
- Clopidogrel moderate
- Aspirin moderate
- Warfarin moderate
- Carbamazepine moderate
- Rifampin moderate
Frequently Asked Questions
What SPL severity band is on file for Nirmatrelvir/Ritonavir + Apixaban?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Nirmatrelvir/Ritonavir has 86 labeled pairs on file vs Apixaban's 12. In the moderate band specifically: Nirmatrelvir/Ritonavir has 30 (also Amlodipine, Tamsulosin, Fluticasone, Clopidogrel); Apixaban has 9 (also Clopidogrel, Aspirin, Warfarin, Carbamazepine).
What mechanism field is on file for Nirmatrelvir/Ritonavir and Apixaban?
Paxlovid blocks the enzymes and proteins that normally clear apixaban from your body, causing the blood thinner to build up. This increases your risk of serious bleeding.
Nirmatrelvir/Ritonavir carries more major-labeled pairs than Apixaban
SPL source-record counts only. This page's band is moderate · classes on file: Nirmatrelvir/Ritonavir (Antiviral (Protease Inhibitor Combination)); Apixaban (Direct Oral Anticoagulant (Factor Xa Inhibitor)).
Nirmatrelvir/Ritonavir has 23 major-labeled pairs vs Apixaban's 0. This page itself is in the moderate band, not the major band.
23 major · 30 moderate · 33 minor · 86 total
- Other moderate peers for Nirmatrelvir/Ritonavir
- Amlodipine
- Tamsulosin
- Fluticasone
- Clopidogrel
0 major · 9 moderate · 3 minor · 12 total
- Other moderate peers for Apixaban
- Clopidogrel
- Aspirin
- Warfarin
- Carbamazepine
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.