Drug interactions
Enoxaparin + Vorapaxar
Severity: Major
Enoxaparin 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
Vorapaxar is a platelet protease-activated receptor-1 antagonist, and combining it with an anticoagulant increases the risk of bleeding, including intracranial hemorrhage. It is contraindicated in patients with prior stroke, TIA or intracranial hemorrhage.
What this interaction means in plain words
Enoxaparin 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 effects of PAR-1 platelet inhibition by vorapaxar and factor Xa inhibition by enoxaparin.
What to do
Confirm no history of stroke, TIA or intracranial hemorrhage and monitor closely for bleeding. Stop vorapaxar if serious 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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References
Other interactions of Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Acetylsalicylic acid + Enoxaparin Major
Frequently asked questions
Can I take Enoxaparin with Vorapaxar?
MediHelp rates the interaction as major. Enoxaparin 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 platelet protease-activated receptor-1 antagonist, and combining it with an anticoagulant increases the risk of bleeding, including intracranial hemorrhage. It is contraindicated in patients with prior stroke, TIA or intracranial hemorrhage.
How serious is the interaction between Enoxaparin 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: Confirm no history of stroke, TIA or intracranial hemorrhage and monitor closely for bleeding. Stop vorapaxar if serious bleeding occurs.
What other medicines interact with Enoxaparin?
MediHelp also lists interactions of Enoxaparin with, for example, Defibrotide, Ketorolac, Mifepristone. The full list is on the Enoxaparin page.
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