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Database of Antiretroviral Drug Interactions

Interactions with Apixaban and Antiretrovirals

Antiretroviral (ARV)Dose of ARVDose of ApixabanEffect on ARV LevelsEffect on Apixaban LevelsPotential Clinical EffectsMechanism of InteractionManagement
Atazanavir727
(ATV)(Reyataz)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Atazanavir/cobicistat727
(others)(Evotaz)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Darunavir727
(DRV)(Prezista)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Darunavir/cobicistat727
(Prezcobix)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Elvitegravir/cobicistat699
(Genvoya, Stribild)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Antiretroviral (ARV)Dose of ARVDose of ApixabanEffect on ARV LevelsEffect on Apixaban LevelsPotential Clinical EffectsMechanism of InteractionManagement
Elvitegravir/ritonavir-boosted protease inhibitor699
---Not studied; may increase apixaban levelsPotential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4

Avoid coadministration. Use alternative anticoagulant

Fosamprenavir727
(FPV)(Lexiva)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Lopinavir/ritonavir727
(LPV/r)(Kaletra)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Ritonavir727
(RTV)(Norvir)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Saquinavir727
(SQV)(Fortovase, Invirase)
---Not studied; may increase levels of apixaban.Potential for increased risk of bleedingInhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

Tipranavir
(TPV)(Aptivus)
--- Not studied; may increase levels of apixaban. Potential for increased risk of bleeding Inhibition of apixaban metabolism via CYP3A4.

Avoid coadministration. Consider alternative anticoagulant

Alternative Agents:
dabigatran

"-" indicates that there are no data available
 699:Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.
 727:Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.