Can I take Apixaban and Ibuprofen together?

Why this happens

Both medicines affect how your blood clots, but in different ways. Apixaban is an anticoagulant (blood thinner) that interferes with clotting proteins. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that prevents platelets (tiny blood cells) from sticking together. When used together, they have an 'additive' effect, making the blood much thinner than intended. Additionally, ibuprofen can irritate the lining of the stomach, making stomach ulcers and bleeding more likely.

You may be experiencing an interaction between apixaban and ibuprofen if:

• You notice unusual bruising or bleeding, such as nosebleeds, bleeding gums, or easy bruising.

• You have blood in your urine or stools, or black, tarry stools.

• You experience severe or persistent headaches, dizziness, or lightheadedness.

• You develop stomach pain, indigestion, or ulcers.

• You feel unusually tired or weak without a clear reason.

• Symptoms appear soon after starting or increasing the dose of ibuprofen while taking apixaban.
  

You should avoid taking ibuprofen while you are on apixaban unless specifically instructed to do so by your doctor. If you need pain relief, paracetamol is generally a safer alternative. If you have already taken them together and notice signs of serious bleeding—such as black, tarry stools, coughing up blood, or severe bruising—seek medical attention immediately. If you have any of the above symptoms, you should:

• Seek urgent medical advice or contact your GP immediately.

• Do not stop taking apixaban unless instructed by a healthcare professional.

• Avoid taking ibuprofen or other NSAIDs until you have spoken to a doctor or pharmacist.

• Tell your healthcare professional about all medicines and supplements you are taking.

• Attend any blood tests or check-ups recommended to monitor bleeding risk.

Combined use (Drug Interaction)

Do not take ibuprofen while taking apixaban. Using both together significantly increases your risk of serious internal bleeding. Use paracetamol for pain relief instead.

Asthma

Do not take ibuprofen if you have asthma that is worsened by aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), as it can trigger a life-threatening asthma attack.

Emergency Surgery or Injury

Always carry your anticoagulant alert card. In the event of a serious injury or emergency surgery, healthcare staff must know you are on apixaban because your blood will not clot normally.

Alcohol

Drinking alcohol while taking these medicines can increase the risk of bleeding in your stomach. It is best to limit your alcohol intake or avoid it altogether. If you do drink, keep to the recommended low-risk limits (no more than 14 units a week).

Food (General)

You should ideally take ibuprofen with food or a glass of milk. This helps to protect your stomach lining and reduces the risk of indigestion or stomach irritation.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.