Newer anticoagulant drugs such as apixaban are increasingly preferred to Vitamin K antagonist agents such as warfarin, but still carry a risk of drug interactions. These interactions can involve medications available over the counter without a prescription, as well as dietary supplements, and have the potential to be serious. In a recent study from North America, almost all of the people surveyed (n = 771) reported the use of some form of OTC product – 33% (n = 266) took at least one OTC product with potentially serious apixaban interactions daily/most days and 53 (6.7%) took multiple products (mean = 2.6 [SD = 2.6]). Daily aspirin was reported by 116 (14.7%; of which 75 [64.7%] also consumed other potentially interacting OTC products). Ibuprofen and naproxen were taken daily/most days by 14 subjects (1.8%) and occasionally by a further 225 (28.5%). Dietary supplements with potentially serious interactions were taken daily/most days by 160 (20.2%). Two thirds of the subjects were either uncertain or incorrect about the potential for increased bleeding from combining NSAIDs and apixaban. Less knowledge about OTC products with potentially serious interactions was associated with greater OTC product use (odds ratio = 0.54; 95% confidence interval = 0.35‐0.85). The researchers advocate for efforts to educate patients and healthcare providers about these potential dangers. Read more here