MajorDirect oral anticoagulants (factor Xa inhibitors)×NSAID, COX-2 preferential, oxicam derivative
Updated · Methodology
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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Eliquis (apixaban) prescribing information (2014)– ; 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: Meloxicam (nº registro 66400), sección 4.5 (2023)– AEMPS, CIMA, nº registro 66400, revisión 11/2023, sección 4.5