Drug interactions
Diclofenac + Rivaroxaban
Severity: Major
Diclofenac and Rivaroxaban: 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
Diclofenac increases bleeding risk when taken with rivaroxaban, including gastrointestinal and other major bleeding. The combination adds mucosal injury and platelet inhibition to anticoagulation.
What this interaction means in plain words
Diclofenac and Rivaroxaban 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.
Diclofenac belongs to Musculoskeletal; Rivaroxaban belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effect: factor Xa inhibition plus NSAID platelet dysfunction and gastric mucosal damage.
What to do
Avoid NSAIDs where possible and use paracetamol or other alternatives. If unavoidable, use the shortest course with gastroprotection and monitor for bleeding and hemoglobin drops.
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 Diclofenac
- Diclofenac + Ketorolac Contraindicated
- Diclofenac + Ketorolac intranasal Contraindicated
- Aceclofenac + Diclofenac Major
- Acemetacin + Diclofenac Major
- Alteplase + Diclofenac Major
- Amiloride + Diclofenac Major
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 Diclofenac with Rivaroxaban?
MediHelp rates the interaction as major. Diclofenac and Rivaroxaban 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. Diclofenac increases bleeding risk when taken with rivaroxaban, including gastrointestinal and other major bleeding. The combination adds mucosal injury and platelet inhibition to anticoagulation.
How serious is the interaction between Diclofenac and Rivaroxaban?
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 NSAIDs where possible and use paracetamol or other alternatives. If unavoidable, use the shortest course with gastroprotection and monitor for bleeding and hemoglobin drops.
What other medicines interact with Diclofenac?
MediHelp also lists interactions of Diclofenac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Diclofenac page.
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