Medication·Interactions·Reviewed June 9, 2026
Apixaban interactions.
Apixaban has 8 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. The full interaction list is below. None of this is a substitute for your prescriber's advice.
Apixaban at a glance.
A quick, data-grounded summary. The full tables are below.
Apixaban has 8 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. The full interaction list is below. None of this is a substitute for your prescriber's advice.
Substances that interact with apixaban.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| St. John's Wort | Conflict | St. John's Wort potently induces CYP3A4 and P-glycoprotein, both of which are major pathways for apixaban metabolism and transport. This induction... details → |
| Fish Oil | Caution | Fish oil has antiplatelet and antithrombotic properties that may increase bleeding risk when combined with apixaban. While moderate doses are likely... details → |
| Garlic Extract | Caution | Concentrated garlic extracts inhibit platelet aggregation via allicin and related organosulfur compounds and have been linked to surgical bleeding.... |
| Ginkgo Biloba | Caution | Ginkgo biloba inhibits platelet-activating factor and platelet aggregation. Case reports document spontaneous bleeding (intracranial, ocular,... details → |
| Ibuprofen | Caution | NSAIDs increase the bleeding risk when combined with DOACs through antiplatelet effects and GI mucosal irritation. While DOACs have fewer food/drug... details → |
| Nattokinase | Caution | Nattokinase is a fibrinolytic enzyme that degrades fibrin and reduces clotting factor levels. Combined with apixaban's factor Xa inhibition, the... |
| Quercetin | Caution | Quercetin inhibits CYP3A4 and P-glycoprotein in vitro. Apixaban is metabolised by CYP3A4 and is a P-gp substrate, so high-dose quercetin supplements... |
| Turmeric/Curcumin | Caution | Curcumin has antiplatelet properties that may increase bleeding risk when combined with apixaban. While no direct pharmacokinetic interaction has... |
The full apixaban profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common apixaban questions.
Quick answers drawn from the tables above.
What interacts with Apixaban?
In the NutriStack database, Apixaban has 8 documented interactions. The most notable include St. John's Wort, Fish Oil, Garlic Extract, Ginkgo Biloba, and Ibuprofen. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Apixaban?
Apixaban is flagged against 1 substance in the database, including St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Is it safe to take St. John's Wort with Apixaban?
NutriStack classifies the St. John's Wort and Apixaban pairing as conflict: St. John's Wort potently induces CYP3A4 and P-glycoprotein, both of which are major pathways for apixaban metabolism and transport. This induction can reduce apixaban... Avoid combining St. John's Wort with apixaban. The FDA and EMA both list strong CYP3A4 inducers as contraindicated with DOACs. Discuss alternative... Always confirm with your prescriber.
Check your whole stack
See how apixaban fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.