Yes, you can safely take Eliquis (apixaban) with calcium and vitamin D supplements
There are no clinically significant drug interactions between apixaban and calcium or vitamin D supplements, and you can take them together without dose adjustments or timing restrictions. The FDA label for Eliquis does not list calcium or vitamin D as interacting substances 1.
Key Points About This Combination
No Pharmacologic Interaction
- Apixaban is metabolized through CYP3A4 and P-glycoprotein pathways 1
- Calcium and vitamin D do not affect these metabolic pathways
- The FDA prescribing information for Eliquis specifically warns about combined P-gp and strong CYP3A4 inhibitors (like ketoconazole, itraconazole, ritonavir), but calcium and vitamin D are not in this category 1
Administration Considerations
- Take Eliquis with or without food as prescribed (typically twice daily) 1
- Calcium and vitamin D can be taken at the same time as Eliquis without concern
- No need to separate doses or adjust timing
Important Caveats About Other Supplements
While calcium and vitamin D are safe with Eliquis, be aware that:
- NSAIDs (ibuprofen, naproxen) and aspirin significantly increase bleeding risk when combined with Eliquis 1, 2
- Many patients taking apixaban use over-the-counter products without recognizing potential interactions - approximately 33% of patients take at least one potentially interacting OTC product daily 2
- Non-vitamin, non-mineral dietary supplements may have unknown interactions and should be discussed with your healthcare provider 2, 3
Recommended Calcium and Vitamin D Dosing
Based on osteoporosis guidelines (the most common reason for these supplements):
- Calcium: Total intake of 1000-1200 mg/day (including dietary sources), with supplemental calcium ideally <1000 mg/day 4
- Vitamin D: 600-800 IU daily, targeting serum 25(OH)D levels ≥20-30 ng/mL 5, 4
- Prefer dietary calcium sources when possible to minimize risk of kidney stones 4
When to Inform Your Doctor
You should tell your healthcare provider about:
- All supplements you're taking, even though calcium and vitamin D are safe with Eliquis 1
- Any new bleeding symptoms (unusual bruising, prolonged bleeding, blood in urine/stool) 1
- Use of aspirin, NSAIDs, or other medications that affect bleeding 1
Bottom line: Calcium and vitamin D supplements do not interact with Eliquis and can be taken together safely. The primary concern with Eliquis is avoiding medications that increase bleeding risk (like NSAIDs and aspirin) or drugs that significantly affect its metabolism through CYP3A4/P-gp pathways, neither of which applies to calcium or vitamin D.