Drug interactions
Anagrelide + Vorapaxar
Severity: Major
Anagrelide and Vorapaxar: major interaction.
Last updated Sources: US FDA label
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
Anagrelide inhibits platelet aggregation and vorapaxar blocks the platelet PAR-1 thrombin receptor, so together they may increase the risk of bleeding. Vorapaxar already carries a labeled bleeding risk, and a thrombocythemia patient on anagrelide may have additional platelet function abnormalities.
What this interaction means in plain words
Anagrelide 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 antiplatelet effects through different pathways of platelet inhibition.
What to do
Avoid the combination where possible, and reassess the need for vorapaxar in patients on anagrelide. If combined, monitor closely for bleeding signs and follow platelet counts and hemoglobin.
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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References
Other interactions of Anagrelide
- Anagrelide + Panobinostat Contraindicated
- Anagrelide + Pimozide Contraindicated
- Anagrelide + Thioridazine Contraindicated
- Anagrelide + Vandetanib Contraindicated
- Abrocitinib + Anagrelide Major
- Alfuzosin + Anagrelide Major
Frequently asked questions
Can I take Anagrelide with Vorapaxar?
MediHelp rates the interaction as major. Anagrelide 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. Anagrelide inhibits platelet aggregation and vorapaxar blocks the platelet PAR-1 thrombin receptor, so together they may increase the risk of bleeding. Vorapaxar already carries a labeled bleeding risk, and a thrombocythemia patient on anagrelide may have additional platelet function abnormalities.
How serious is the interaction between Anagrelide 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: Avoid the combination where possible, and reassess the need for vorapaxar in patients on anagrelide. If combined, monitor closely for bleeding signs and follow platelet counts and hemoglobin.
What other medicines interact with Anagrelide?
MediHelp also lists interactions of Anagrelide with, for example, Panobinostat, Pimozide, Thioridazine. The full list is on the Anagrelide page.
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