Drug interactions
Amiodarone + Rivaroxaban
Severity: Moderate
Amiodarone and Rivaroxaban: moderate 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
Amiodarone can raise rivaroxaban exposure through its inhibition of P-glycoprotein and modest effect on CYP3A4. The effect is usually small in patients with normal kidney function, but in renal impairment the rise may be meaningful and increase bleeding risk.
What this interaction means in plain words
Amiodarone and Rivaroxaban can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amiodarone belongs to Cardiovascular; Rivaroxaban belongs to Cardiovascular.
Why it happens
Amiodarone inhibits intestinal and renal P-glycoprotein and weakly inhibits CYP3A4, reducing rivaroxaban clearance.
What to do
Monitor for signs of bleeding and check renal function regularly. In patients with renal impairment, use the combination only if benefit outweighs risk and consider an alternative anticoagulant.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Other interactions of Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Frequently asked questions
Can I take Amiodarone with Rivaroxaban?
MediHelp rates the interaction as moderate. Amiodarone and Rivaroxaban can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Amiodarone can raise rivaroxaban exposure through its inhibition of P-glycoprotein and modest effect on CYP3A4. The effect is usually small in patients with normal kidney function, but in renal impairment the rise may be meaningful and increase bleeding risk.
How serious is the interaction between Amiodarone and Rivaroxaban?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of bleeding and check renal function regularly. In patients with renal impairment, use the combination only if benefit outweighs risk and consider an alternative anticoagulant.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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