MODERATE — Monitor Closely
🟡 MODERATE — Limit grapefruit with Apixaban.
Evidence level: MODERATE
Grapefruit can increase apixaban blood thinner levels, slightly raising your risk of bleeding.
Grapefruit inhibits CYP3A4, which partially metabolizes apixaban. Moderate increases in levels may increase bleeding risk.
Limit grapefruit to occasional small amounts. Be vigilant for signs of bleeding.
Be consistent with Grapefruit intake. If on warfarin, vitamin K-rich foods (leafy greens, broccoli, Brussels sprouts) affect clotting — don't avoid them, but eat consistent amounts week to week. Cranberry juice, grapefruit, and alcohol can amplify anticoagulant effects. Apixaban at the same time daily.
Elderly, patients on dual antiplatelet therapy, kidney disease
Unusual bruising, prolonged bleeding, blood in urine or stool
Discuss grapefruit intake when reviewing anticoagulation therapy
This medication combination requires careful medical oversight. Your doctor or anticoagulation clinic can adjust doses or select alternatives with fewer bleeding risks. Frequent INR monitoring is essential.
Grapefruit can increase apixaban blood thinner levels, slightly raising your risk of bleeding.
Be consistent with Grapefruit intake. If on warfarin, vitamin K-rich foods (leafy greens, broccoli, Brussels sprouts) affect clotting — don't avoid them, but eat consistent amounts week to week. Cranberry juice, grapefruit, and alcohol can amplify anticoagulant effects. Apixaban at the same time daily.
Unusual bruising, prolonged bleeding, blood in urine or stool
This medication combination requires careful medical oversight. Your doctor or anticoagulation clinic can adjust doses or select alternatives with fewer bleeding risks. Frequent INR monitoring is essential.
Discuss grapefruit intake when reviewing anticoagulation therapy
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