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Can I take Aspirin and Apixaban together?

Drug interaction guide

Taking aspirin and apixaban together significantly increases your risk of serious bleeding. This includes internal bleeding, such as in the stomach or brain, as well as bleeding from the gums, nosebleeds, or bruising that happens more easily than usual.

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Why this happens

Both medicines work to prevent blood clots but in different ways. Apixaban is an anticoagulant (blood thinner) that interferes with clotting proteins, while aspirin is an antiplatelet medicine that stops blood cells from sticking together. Using both at the same time makes the blood much less likely to clot, which increases the risk of haemorrhage (uncontrolled bleeding).

Do not take aspirin with apixaban unless your doctor has specifically told you to do so for a particular medical reason (such as having a heart stent). If you need pain relief, paracetamol is generally a safer choice. If you are already taking both, do not stop without talking to your doctor, but seek immediate medical help if you notice signs of bleeding, such as black tarry stools, blood in your urine, or coughing up blood.

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Surgery or dental procedures

You must inform your surgeon or dentist that you are taking these medicines well in advance of any procedure. They significantly increase your risk of bleeding and may need to be paused temporarily to prevent serious complications.

Use of NSAIDs (e.g. ibuprofen, naproxen)

Do not take anti-inflammatory painkillers like ibuprofen or naproxen while on these medicines unless specifically prescribed. Combining them significantly increases your risk of internal stomach bleeding.

Asthma

If you have asthma, aspirin can occasionally trigger a severe worsening of symptoms or an allergic-type reaction. Do not take aspirin if you have ever noticed your asthma getting worse after taking similar painkillers.

Alcohol

Drinking alcohol while taking aspirin can increase the risk of irritation and bleeding in your stomach. It is best to limit your alcohol intake or avoid it altogether if you have a history of stomach issues.

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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.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 25 Jan 2026 | Originally published
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