MajorDirect oral anticoagulants (factor Xa inhibitors)×Glucocorticoids
Updated · Methodology
Mechanism
Dexamethasone is a CYP3A4 and P-glycoprotein inducer. It reduces apixaban (a substrate of both) levels by 30–50%, raising thrombotic event risk.
Symptoms
The patient feels no symptoms. Stroke risk in atrial fibrillation rises, as do deep vein thrombosis and pulmonary embolism risks.
Management
For prolonged systemic dexamethasone, do not increase apixaban (no titration data); switch to warfarin with INR monitoring instead. For short dexamethasone pulse therapy (1–3 days), no clinically significant effect.
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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Eliquis (apixaban) prescribing information (2021)– ; DailyMed setid e9481622-7cc6-418a-acb6-c5450daae9b0
- AEMPS: Ficha técnica de Eliquis 5 mg comprimidos recubiertos con película (apixabán) (2026)– AEMPS, CIMA (texto EMA), nº registro 111691009, secciones 4.4 y 4.5
- AEMPS: Ficha técnica: Dexametasona (nº registro 86123), sección 4.5 (2026)– AEMPS, CIMA, nº registro 86123, revisión 05/2026, sección 4.5