NutriStack
Apixaban and Fish Oil, a caution.
Fish oil has antiplatelet and antithrombotic properties that may increase bleeding risk when combined with apixaban. While moderate doses are likely safe for most patients, higher doses (above 3g/day) create a more significant additive bleeding risk.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 4 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Fish oil has antiplatelet and antithrombotic properties that may increase bleeding risk when combined with apixaban. While moderate doses are likely safe for most patients, higher doses (above 3g/day) create a more significant additive bleeding risk.
Mechanism. EPA and DHA reduce platelet aggregation by competing with arachidonic acid for cyclooxygenase, decreasing thromboxane A2 production. This antiplatelet effect adds to apixaban's Factor Xa inhibition, creating additive bleeding risk through complementary pathways.
Recommendation. Low-to-moderate dose fish oil (1-2g/day) can generally be used with apixaban under medical supervision. Avoid high doses. Report any unusual bleeding or bruising to your healthcare provider.
Sources (4)
- Bays HE. Safety considerations with omega-3 fatty acid therapy. Am J Cardiol. 2007;99(6A):35C-43C. PMID 17368277
- Liao Y, Xie B, Zhang H et al.. Efficacy of omega-3 PUFAs in depression: A meta-analysis.. Translational Psychiatry. 2019. PMID 31383846
- Wei BZ, Li L, Dong CW et al.. The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake, and Blood Markers.. American Journal of Clinical Nutrition. 2023. PMID 37028557
- Uchida Y, Tsuji K, Ochi E. Effects of Omega-3 fatty acids supplementation and resistance training on skeletal muscle.. Clinical Nutrition ESPEN. 2024. PMID 38777432
Stack Score
How this pair moves the number.
Effect on the composite score
If both Apixaban and Fish Oil are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
Check your full routine
One pair was the worked example. NutriStack runs every pair in your stack at once.
Drop in your supplements and prescriptions and the public database surfaces every interaction, synergy, timing rule, and contraindication, every one linked to its primary source.