Apixaban and Ritonavir: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Apixaban and Ritonavir unless specifically directed by your doctor.
How Apixaban interacts with Ritonavir
Ritonavir strongly inhibits CYP3A4 and P-glycoprotein, both important for apixaban clearance. Apixaban exposure and bleeding risk can increase substantially.
What you should do
Avoid or use label-directed dose reduction only when appropriate. Consider an anticoagulant that can be monitored or is less affected by CYP3A4/P-glycoprotein inhibition.
Key facts
Severity
Major — avoid combination
Mechanism
Ritonavir strongly inhibits CYP3A4 and P-glycoprotein, both important for apixaban clearance. Apixaban exposure and blee...
Action
Avoid or use label-directed dose reduction only when appropriate. Consider an anticoagulant that can be monitored or is ...
Frequently asked questions
Can I take Apixaban and Ritonavir together?
No — this combination should generally be avoided. Avoid or use label-directed dose reduction only when appropriate. Consider an anticoagulant that can be monitored or is less affected by CYP3A4/P-glycoprotein inhibition.
What is the severity of this interaction?
The interaction between Apixaban and Ritonavir is classified as Major — avoid combination. Ritonavir strongly inhibits CYP3A4 and P-glycoprotein, both important for apixaban clearance. Apixaban exposure and bleeding risk can increase substantially.
What should I do if I'm prescribed both?
Avoid or use label-directed dose reduction only when appropriate. Consider an anticoagulant that can be monitored or is less affected by CYP3A4/P-glycoprotein inhibition. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.