Ceftriaxone and Eliquis (Apixaban) Compatibility
Yes, you can safely receive a ceftriaxone injection while taking Eliquis (apixaban) - there is no clinically significant drug interaction between these medications.
No Direct Drug Interaction
- Ceftriaxone is a third-generation cephalosporin antibiotic that does not interact with apixaban's mechanism of action as a direct factor Xa inhibitor 1
- Apixaban is metabolized primarily through CYP3A4/5 enzymes and P-glycoprotein pathways, while ceftriaxone does not significantly affect these pathways 2
- The anticoagulant effect of apixaban remains stable when ceftriaxone is administered, as ceftriaxone is not a P-glycoprotein inhibitor or strong CYP3A4 inducer/inhibitor 1
Important Bleeding Risk Considerations
While the combination is safe, you should be aware of general bleeding precautions when on apixaban:
- Monitor for bleeding signs: Any anticoagulant therapy carries inherent bleeding risk, with apixaban showing major bleeding rates of 2.13% per year in clinical trials 3
- Avoid concomitant antiplatelet agents: Concurrent use of aspirin or NSAIDs significantly increases bleeding risk and should be avoided unless absolutely necessary 3
- Renal function matters: If you have kidney impairment (CrCl <30 mL/min), apixaban levels may be elevated, increasing bleeding risk, though this is unrelated to ceftriaxone 2, 4
Clinical Context
- The primary concerns with apixaban relate to its reversal in emergency bleeding situations (using andexanet alfa) or interactions with specific P-glycoprotein inhibitors and strong CYP3A4 modulators - none of which apply to ceftriaxone 1
- Ceftriaxone administration for bacterial infections does not require dose adjustment of apixaban or temporary discontinuation 2
Proceed Confidently
You can receive your ceftriaxone injection without interrupting or adjusting your Eliquis therapy. Simply maintain awareness of general bleeding precautions that apply to all patients on anticoagulation, regardless of antibiotic use 5, 6.