Prostate Cancer Drugs Do Not Interact With DOACs to Increase Bleeding Risk

Medically reviewed by Carmen Pope, BPharm. Last updated on March 9, 2026.

via HealthDay

MONDAY, March 9, 2026 -- For patients with prostate cancer, concurrent use of enzalutamide, apalutamide, or abiraterone with direct oral anticoagulants (DOACs) does not increase the risks for thrombosis or bleeding, according to a study published online March 9 in Cancer.

Tzu‐Fei Wang, M.D., from the University of Ottawa at The Ottawa Hospital in Ontario, Canada, and colleagues examined the risk for thrombosis or bleeding among 2,997 adults with prostate cancer who were prescribed a DOAC and a potentially interacting androgen receptor pathway inhibitor compared to non-DOACs between 2012 and 2023. Analyses were stratified based on DOAC inducer (enzalutamide or apalutamide, which might increase thrombosis risk) or DOAC inhibitor (abiraterone, which might increase bleeding risk).

The researchers observed no increased risk for all thrombosis in the DOAC versus non-DOAC groups among patients who received enzalutamide or apalutamide. No significant differences were seen in any bleeding events comparing DOAC and non-DOAC groups among those who received abiraterone. In multiple sensitivity analyses, the results were consistent.

"Our findings suggest that pharmacokinetic drug-drug interaction concerns may not translate into adverse clinical outcomes in the real world," Wang said in a statement. "These results can help clinicians and patients feel more confident when managing anticoagulation alongside modern prostate cancer treatments."

Two authors disclosed ties to the biopharmaceutical industry.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

Source: HealthDay

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