MAJOR — Use With Caution
FDA-documented interaction. Apixaban levels reduced ~54%. Avoid concurrent use. Consider warfarin (monitorable) during rifampin treatment.
Evidence level: STRONG
Rifampin can reduce Eliquis (apixaban) effectiveness by more than half, potentially leaving you unprotected against blood clots.
Rifampin induces CYP3A4 and P-gp, reducing apixaban levels by approximately 54%. FDA apixaban label warns about strong dual CYP3A4/P-gp inducers.
If you need rifampin, your doctor may switch you to warfarin so your blood thinning can be monitored and adjusted.
Monitor closely. Many antibiotics amplify anticoagulant effects by disrupting gut flora that produce vitamin K. Apixaban levels may spike during antibiotic courses. If on warfarin, request more frequent INR monitoring. Take each at their normal prescribed times.
Atrial fibrillation, prior VTE, mechanical heart valve
Signs of blood clots: leg pain/swelling, chest pain, shortness of breath, stroke symptoms
Switch to warfarin (INR-monitorable) during rifampin course. Discuss alternative TB regimens.
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.
Rifampin can reduce Eliquis (apixaban) effectiveness by more than half, potentially leaving you unprotected against blood clots.
Monitor closely. Many antibiotics amplify anticoagulant effects by disrupting gut flora that produce vitamin K. Apixaban levels may spike during antibiotic courses. If on warfarin, request more frequent INR monitoring. Take each at their normal prescribed times.
Signs of blood clots: leg pain/swelling, chest pain, shortness of breath, stroke symptoms
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.
Switch to warfarin (INR-monitorable) during rifampin course. Discuss alternative TB regimens.
Or browse the full interaction database (121,000+ pairs).