Apixaban and Bismuth subcitrate, metronidazole, and tetracycline interaction

Apixaban and Bismuth subcitrate, metronidazole, and tetracycline: the Bismuth subcitrate, metronidazole, and tetracycline prescribing label describes an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Bismuth subcitrate, metronidazole, and tetracycline (Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride) label · effective 2026-04-13

Moderate

Metronidazole has been reported to potentiate the anticoagulant effect of warfarin, and other oral coumarin anticoagulants, resulting in a prolongation of prothrombin time.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Anticoagulants: Potentiation of the anticoagulant effect; Prothrombin time, International Normalized Ratio (INR), or other suitable anticoagulation tests should be closely monitored.

Drug interactionsby drug classView label on DailyMed
Minor

Anticoagulants Bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride may alter the anticoagulant effects of warfarin and other oral coumarin anticoagulants.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.