Can I take Apixaban and Empagliflozin together?

Why this happens

Apixaban (a blood thinner) and empagliflozin (a diabetes medication) are processed by different pathways in the body. Apixaban is mainly broken down by specific liver enzymes (CYP3A4) and a transport protein (P-gp), while empagliflozin is processed through a different liver pathway (glucuronidation) and removed by the kidneys. They do not interfere with how each other works or how they are cleared from the system.

What you should do

You can continue taking both medications as prescribed by your doctor. However, because empagliflozin can have a mild diuretic effect (making you pass more urine), ensure you stay well-hydrated. Always inform your healthcare provider if you notice any unusual bruising or bleeding, which is a general precaution when taking any blood thinner like apixaban.

Important precautions

Surgery or dental procedures

You must tell your surgeon or dentist you are taking apixaban before any procedure, as it significantly increases your risk of bleeding and may need to be stopped temporarily.

Diabetic Ketoacidosis (DKA)

Empagliflozin can cause a serious condition called ketoacidosis even if your blood sugar levels are near normal. Seek urgent medical help if you experience nausea, vomiting, or stomach pain.

Fournier's gangrene - empagliflozin

Seek immediate medical attention if you experience pain, tenderness, redness, or swelling in the genital or anal area, accompanied by fever or malaise.

Food and drink warnings

Alcohol

While there is no direct chemical interaction, you should be cautious. For apixaban, heavy drinking increases the risk of stomach bleeding. For empagliflozin, alcohol can increase the risk of dehydration, low blood sugar (hypoglycaemia), and a serious condition called ketoacidosis. Stick to moderate amounts.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.