Major
Apixaban × meloxicam
Direct oral anticoagulants (factor Xa inhibitors)×NSAID, COX-2 preferential, oxicam derivative
Mechanism
Apixaban is a direct factor Xa inhibitor; meloxicam blocks platelet function and injures the GI mucosa. Additive GI bleeding risk increases 2- to 3-fold.
Symptoms
Black or tarry stools (melena), vomiting blood or coffee-ground material, epigastric pain. Risk multiplies in older patients and with prior peptic ulcer disease.
Management
Avoid prolonged combination. If meloxicam is needed for a short course, use the minimum effective dose for 5–7 days with pantoprazole cover. For chronic analgesia: paracetamol or celecoxib.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.