Major
Apixaban × naproxen
Direct oral anticoagulants (factor Xa inhibitors)×NSAID, propionic acid derivative
Mechanism
Similar to apixaban + meloxicam. Additive GI bleeding risk with an anticoagulant and NSAID.
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 naproxen 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.