Apixaban and E-400
Determining the interaction of Apixaban and E-400 and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Talk to your doctor before using vitamin E together with apixaban. Products containing vitamin E may increase the effects of apixaban and cause you to bleed more easily. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Professional:MONITOR: Limited data suggest that vitamin E may potentiate the effects of anticoagulants and platelet inhibitors. Vitamin E is thought to inhibit the oxidation of reduced vitamin K and interfere with the functions of vitamin K-dependent clotting factors. In one study, administration of vitamin E 42 units/day for one month increased the hypoprothrombinemic effect of a single dose of dicumarol in 3 healthy volunteers, as demonstrated by a decrease in prothrombin activity from 52% to 33% thirty-six hours postdose. The interaction was also suspected in a patient who developed ecchymoses and hematuria following two months of vitamin E supplementation at a dosage of 800 to 1200 units/day while taking warfarin. In contrast, two studies found no significant effect of vitamin E on the hypoprothrombinemic effect of chronic warfarin therapy when administered at relatively high dosages (800 or 1200 units/day) to 21 subjects for one month or at low dosages (100 or 400 units/day) to 12 subjects for four weeks. With respect to antiplatelet activities, data from in vitro and ex vivo human studies suggest that vitamin E can inhibit collagen-induced platelet activation and protein kinase C-dependent platelet aggregation. However, a clinically significant interaction with antiplatelet agents has not been reported.
MANAGEMENT: Patients should consult a healthcare provider before taking any nutritional supplements like vitamin E. Close clinical and laboratory observation for hematologic complications may be appropriate when vitamin E supplementation at dosages greater than 400 units/day is initiated in patients stabilized on anticoagulant or antiplatelet therapy. The dose of the anticoagulant or antiplatelet drug may require adjustment during and after treatment with vitamin E. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
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Generic Name: apixaban
Brand name: Eliquis, Eliquis Starter Pack for Treatment of DVT and PE
Synonyms: n.a.
Generic Name: vitamin e
Brand name: Aqua-E, Aquasol E, Aquavite-E, Aqueous Vitamin E, E-400 Clear, Alph-E, Alph-E-Mixed, Alph-E-Mixed 1000, E-400, E-400-Clear, E-400-Mixed, E-Max-1000, E-Pherol, Formula E 400, Natural Vitamin E, Nutr-E-Sol, Vita-Plus E
Synonyms: E-400 Clear
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.