Can I take Apixaban and Rybelsus together?

Why this happens

Apixaban is an anticoagulant (blood thinner) that works by blocking a clotting factor called Factor Xa. Rybelsus is a GLP-1 receptor agonist used for type 2 diabetes that mimics a natural hormone to lower blood sugar. They are processed by different pathways in the liver and kidneys, and they do not share the same targets in the body.

What you should do

You can safely take these two medicines together as prescribed by your doctor. However, because Rybelsus can cause nausea or vomiting when you first start taking it, be mindful that severe vomiting could potentially affect how much apixaban your body absorbs. If you experience persistent vomiting, contact your doctor for advice. Always follow the specific dosing instructions for Rybelsus (taking it on an empty stomach with a small sip of water) to ensure it works correctly.

Important precautions

Surgery or dental procedures

You must tell your surgeon or dentist you are taking apixaban well in advance of any procedure. You may need to stop taking it temporarily to prevent life-threatening bleeding during surgery.

Pancreatitis

Stop taking Rybelsus and seek immediate medical help if you develop severe, persistent stomach pain (which may radiate to your back), as this can be a sign of acute pancreatitis.

Serious injury or head trauma

Because apixaban prevents clotting, a head injury or major fall requires immediate emergency medical review, even if you feel fine, due to the risk of internal bleeding that cannot easily be stopped.

Food and drink warnings

Food, drink, and other oral medicines

Rybelsus must be taken on an empty stomach with a small sip of plain water (no more than 120ml). You must wait at least 30 minutes before eating, drinking anything else, or taking other oral medicines. If you do not wait, the medicine will not be absorbed properly and will not work.

Alcohol

There is no direct interaction between alcohol and these medicines. However, alcohol can increase the risk of stomach bleeding with apixaban and can cause unpredictable blood sugar changes with Rybelsus. Moderation is advised.

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.