Drug interactions
Fluconazole + Rivaroxaban
Severity: Moderate
Fluconazole 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
Rivaroxaban is cleared via CYP3A4 and P-gp, and fluconazole as a moderate CYP3A4 inhibitor may increase its exposure. This raises the risk of bleeding, particularly in renal impairment.
What this interaction means in plain words
Fluconazole 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.
Fluconazole belongs to Anti Fungals; Rivaroxaban belongs to Cardiovascular.
Why it happens
Fluconazole inhibits CYP3A4, reducing rivaroxaban clearance.
What to do
Monitor for bleeding signs, especially in patients with renal impairment or other bleeding risks. Consider an alternative antifungal or anticoagulant if renal function is reduced.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole 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 Fluconazole with Rivaroxaban?
MediHelp rates the interaction as moderate. Fluconazole 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. Rivaroxaban is cleared via CYP3A4 and P-gp, and fluconazole as a moderate CYP3A4 inhibitor may increase its exposure. This raises the risk of bleeding, particularly in renal impairment.
How serious is the interaction between Fluconazole 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 bleeding signs, especially in patients with renal impairment or other bleeding risks. Consider an alternative antifungal or anticoagulant if renal function is reduced.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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