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Can I take Apixaban and Cocodamol together?

Drug interaction guide

Taking apixaban and co-codamol together can increase your risk of bleeding, particularly in the stomach or gut. This is because the paracetamol in co-codamol can sometimes slightly increase the blood-thinning effect of apixaban, while the codeine can occasionally cause constipation, which may lead to straining and a higher risk of local bleeding (like piles).

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Why this happens

While paracetamol is generally the safest painkiller to take with blood thinners, taking it regularly or in high doses can enhance the effect of apixaban (an anticoagulant), making the blood take longer to clot. Additionally, codeine is an opioid that slows down the gut; if this causes severe constipation, the physical strain can increase the risk of small blood vessels bursting.

You can take these together for short-term pain relief, but you should be cautious. Stick to the lowest dose possible for the shortest amount of time. If you need to take co-codamol for more than 3 or 4 days, speak to your GP or pharmacist. Seek medical advice immediately if you notice signs of unusual bleeding, such as dark/tarry stools, coughing up blood, or bruising that appears for no reason. To prevent constipation from the codeine, drink plenty of water and eat high-fibre foods.

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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.

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Article history

The information on this page is written and peer reviewed by qualified clinicians.

  • 14 Mar 2026 | Originally published
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