Drug interactions
Cenobamate + Rivaroxaban
Severity: Moderate
Cenobamate 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
Cenobamate can induce CYP3A4 and may lower rivaroxaban exposure. Reduced anticoagulant effect could raise the risk of thromboembolic events such as stroke or venous thrombosis.
What this interaction means in plain words
Cenobamate 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.
Cenobamate belongs to Central Nervous System; Rivaroxaban belongs to Cardiovascular.
Why it happens
Cenobamate induces CYP3A4 (and possibly other pathways), increasing rivaroxaban clearance.
What to do
Monitor for signs of reduced anticoagulant efficacy and reassess the need for the combination. Consider an alternative anticoagulant or antiseizure agent if thromboembolic events occur or efficacy is a concern.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Other interactions of Cenobamate
Frequently asked questions
Can I take Cenobamate with Rivaroxaban?
MediHelp rates the interaction as moderate. Cenobamate 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. Cenobamate can induce CYP3A4 and may lower rivaroxaban exposure. Reduced anticoagulant effect could raise the risk of thromboembolic events such as stroke or venous thrombosis.
How serious is the interaction between Cenobamate 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 reduced anticoagulant efficacy and reassess the need for the combination. Consider an alternative anticoagulant or antiseizure agent if thromboembolic events occur or efficacy is a concern.
What other medicines interact with Rivaroxaban?
MediHelp also lists interactions of Rivaroxaban with, for example, Defibrotide, Ketoconazole, Ketorolac. The full list is on the Rivaroxaban page.
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