Drug interactions
Fluoxetine + Rivaroxaban
Severity: Moderate
Fluoxetine 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
Fluoxetine impairs platelet function and raises bleeding risk with rivaroxaban. Fluoxetine's modest CYP3A4 inhibition may contribute slightly.
What this interaction means in plain words
Fluoxetine 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.
Fluoxetine belongs to Central Nervous System; Rivaroxaban belongs to Cardiovascular.
Why it happens
SSRI-related platelet serotonin depletion reduces aggregation, adding to factor Xa inhibition.
What to do
Monitor for bleeding and hemoglobin. Consider gastroprotection in high-risk patients.
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 Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Other interactions of Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Rivaroxaban?
MediHelp rates the interaction as moderate. Fluoxetine 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. Fluoxetine impairs platelet function and raises bleeding risk with rivaroxaban. Fluoxetine's modest CYP3A4 inhibition may contribute slightly.
How serious is the interaction between Fluoxetine 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 and hemoglobin. Consider gastroprotection in high-risk patients.
What other medicines interact with Rivaroxaban?
MediHelp also lists interactions of Rivaroxaban with, for example, Defibrotide, Ketoconazole, Ketorolac. The full list is on the Rivaroxaban page.
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