apixaban + rivaroxaban

Apixaban + rivaroxaban refers to the concomitant use of two direct oral anticoagulant (DOAC) factor Xa inhibitors without a single fixed-dose combination product. Both are orally available small-molecule anticoagulants that selectively and reversibly inhibit coagulation factor Xa, thereby reducing thrombin generation and fibrin clot formation.[1][2][3][4][5] Apixaban (commonly marketed as Eliquis) and rivaroxaban (commonly marketed as Xarelto) are each approved individually for prevention of stroke and systemic embolism in nonvalvular atrial fibrillation, and for treatment and secondary prevention of venous thromboembolism, among other indications.[1][2][3][4] Their combined use is not standard therapy and would generally be considered off-label and potentially associated with markedly increased bleeding risk due to additive pharmacodynamic anticoagulant effects.[2][3][4]