Can I take Apixaban and Levomepromazine together?
Drug interaction guide
Originally published 25 Jan 2026
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Taking apixaban and levomepromazine together may increase your risk of bleeding. Levomepromazine can sometimes cause a drop in the number of platelets in your blood (the cells that help your blood clot). When combined with a blood thinner like apixaban, this makes it easier for you to bruise or bleed. Additionally, levomepromazine can cause side effects like dizziness or fainting when you stand up, which increases the risk of falls and subsequent injury while on a blood thinner.
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Why this happens
Levomepromazine can occasionally cause blood disorders (such as thrombocytopenia) which reduce the body's ability to form clots. This adds to the blood-thinning effect of apixaban (a pharmacodynamic interaction). There is also a risk of 'orthostatic hypotension' (dizzy spells) from the levomepromazine, which increases the risk of trauma.
What you should do
You should use this combination with caution. Speak to your doctor before taking these together. If you are prescribed both, watch closely for signs of unusual bleeding, such as bleeding gums, nosebleeds, dark/tarry stools, or bruising that appears for no reason. Seek medical help immediately if you have a serious fall or hit your head.
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Important precautions
Surgery or dental procedures
You must inform your surgeon or dentist that you are taking apixaban before any procedure, as it may need to be stopped temporarily to prevent dangerous bleeding.
Dementia in elderly patients
This medicine carries an increased risk of stroke and death when used to treat behavioural problems in elderly patients with dementia.
Risk of falls
Levomepromazine can cause significant drowsiness and dizziness, which greatly increases the risk of falling; because apixaban thins your blood, a fall is much more likely to result in serious internal bleeding or a head injury.
Food and drink warnings
Alcohol
Drinking alcohol while taking levomepromazine can make you feel very sleepy and increase the risk of side effects like dizziness or fainting. It is best to avoid alcohol altogether while on this medication.
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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.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
25 Jan 2026 | Originally published
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