Drug interactions
Indinavir + Rivaroxaban
Severity: Major
Indinavir and Rivaroxaban: major 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
Indinavir is a strong CYP3A4 inhibitor and raises rivaroxaban concentrations. The higher exposure increases the likelihood of serious bleeding.
What this interaction means in plain words
Indinavir 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.
Why it happens
Inhibition of CYP3A4 metabolism of rivaroxaban, with possible P-gp effects.
What to do
Avoid coadministration and use an alternative anticoagulant; if unavoidable, monitor for bleeding.
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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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 Indinavir with Rivaroxaban?
MediHelp rates the interaction as major. Indinavir 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. Indinavir is a strong CYP3A4 inhibitor and raises rivaroxaban concentrations. The higher exposure increases the likelihood of serious bleeding.
How serious is the interaction between Indinavir 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 coadministration and use an alternative anticoagulant; if unavoidable, monitor for bleeding.
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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