Can I take Apixaban and Levomepromazine together?

Why this happens

Levomepromazine can occasionally cause blood disorders (such as thrombocytopenia) which reduce the body's ability to form clots. This adds to the blood-thinning effect of apixaban (a pharmacodynamic interaction). There is also a risk of 'orthostatic hypotension' (dizzy spells) from the levomepromazine, which increases the risk of trauma.

What you should do

You should use this combination with caution. Speak to your doctor before taking these together. If you are prescribed both, watch closely for signs of unusual bleeding, such as bleeding gums, nosebleeds, dark/tarry stools, or bruising that appears for no reason. Seek medical help immediately if you have a serious fall or hit your head.

Important precautions

Surgery or dental procedures

You must inform your surgeon or dentist that you are taking apixaban before any procedure, as it may need to be stopped temporarily to prevent dangerous bleeding.

Dementia in elderly patients

Levomepromazine carries an increased risk of stroke and death when used to treat behavioural problems in elderly patients with dementia.

Risk of falls

Levomepromazine can cause significant drowsiness and dizziness, which greatly increases the risk of falling; because apixaban thins your blood, a fall is much more likely to result in serious internal bleeding or a head injury.

Food and drink warnings

Alcohol

Drinking alcohol while taking levomepromazine can make you feel very sleepy and increase the risk of side effects like dizziness or fainting. It is best to avoid alcohol altogether while on this medication.

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.