Drug interactions
Alteplase + Vorapaxar
Severity: Major
Alteplase and Vorapaxar: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Vorapaxar is a PAR-1 antagonist with potent antiplatelet effect and a long duration of action. With alteplase, there is a major risk of bleeding, including intracranial hemorrhage.
What this interaction means in plain words
Alteplase and Vorapaxar can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive effect of PAR-1 platelet inhibition and plasmin-mediated fibrinolysis.
What to do
Vorapaxar's long-lasting effect means it may still be active during thrombolysis, so weigh the risk and benefit carefully. Monitor closely for bleeding and neurological change.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Alteplase
- Alteplase + Defibrotide Contraindicated
- Alteplase + Reteplase Contraindicated
- Alteplase + Tenecteplase Contraindicated
- Acetylsalicylic acid + Alteplase Major
- Alteplase + Apixaban Major
- Alteplase + Argatroban Major
Frequently asked questions
Can I take Alteplase with Vorapaxar?
MediHelp rates the interaction as major. Alteplase and Vorapaxar can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Vorapaxar is a PAR-1 antagonist with potent antiplatelet effect and a long duration of action. With alteplase, there is a major risk of bleeding, including intracranial hemorrhage.
How serious is the interaction between Alteplase and Vorapaxar?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Vorapaxar's long-lasting effect means it may still be active during thrombolysis, so weigh the risk and benefit carefully. Monitor closely for bleeding and neurological change.
What other medicines interact with Alteplase?
MediHelp also lists interactions of Alteplase with, for example, Defibrotide, Reteplase, Tenecteplase. The full list is on the Alteplase page.
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