Drug interactions
Clopidogrel + Vorapaxar
Severity: Major
Clopidogrel 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 that adds antiplatelet effect to clopidogrel, increasing the risk of bleeding including intracranial hemorrhage. Vorapaxar is used with aspirin and/or clopidogrel in trials and labeling, but bleeding risk is clearly increased.
What this interaction means in plain words
Clopidogrel 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 pharmacodynamic platelet inhibition through PAR-1 antagonism and P2Y12 blockade.
What to do
Use only in patients without prior stroke, TIA or intracranial hemorrhage, and monitor closely for bleeding. Stop vorapaxar if stroke, TIA or active bleeding occurs.
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 Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Vorapaxar?
MediHelp rates the interaction as major. Clopidogrel 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 that adds antiplatelet effect to clopidogrel, increasing the risk of bleeding including intracranial hemorrhage. Vorapaxar is used with aspirin and/or clopidogrel in trials and labeling, but bleeding risk is clearly increased.
How serious is the interaction between Clopidogrel 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: Use only in patients without prior stroke, TIA or intracranial hemorrhage, and monitor closely for bleeding. Stop vorapaxar if stroke, TIA or active bleeding occurs.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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