Drug interactions
Dronedarone + Rivaroxaban
Severity: Major
Dronedarone and Rivaroxaban: major interaction.
Last updated Sources: UK SmPC
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
Rivaroxaban is eliminated through CYP3A4 and P-glycoprotein, both inhibited by dronedarone. Exposure may rise, increasing bleeding risk, especially in renal impairment.
What this interaction means in plain words
Dronedarone 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.
Dronedarone belongs to Cardiovascular; Rivaroxaban belongs to Cardiovascular.
Why it happens
Dronedarone inhibits CYP3A4 and P-glycoprotein, reducing rivaroxaban clearance.
What to do
Monitor closely for bleeding and assess renal function; avoid in moderate to severe renal impairment. Consider an alternative anticoagulant if bleeding risk is high.
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 Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone 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 Dronedarone with Rivaroxaban?
MediHelp rates the interaction as major. Dronedarone 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. Rivaroxaban is eliminated through CYP3A4 and P-glycoprotein, both inhibited by dronedarone. Exposure may rise, increasing bleeding risk, especially in renal impairment.
How serious is the interaction between Dronedarone 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: Monitor closely for bleeding and assess renal function; avoid in moderate to severe renal impairment. Consider an alternative anticoagulant if bleeding risk is high.
What other medicines interact with Dronedarone?
MediHelp also lists interactions of Dronedarone with, for example, Adagrasib, Amiodarone, Arsenic trioxide. The full list is on the Dronedarone page.
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