Drug interactions
Istradefylline + Rivaroxaban
Severity: Moderate
Istradefylline 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
Istradefylline at 40 mg daily increases exposure to CYP3A4 substrates, so it could raise rivaroxaban levels and bleeding risk. At 20 mg daily this effect was not seen.
What this interaction means in plain words
Istradefylline 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.
Istradefylline belongs to Central Nervous System; Rivaroxaban belongs to Cardiovascular.
Why it happens
Dose-dependent inhibition of CYP3A4 (and possibly P-glycoprotein) reduces rivaroxaban clearance.
What to do
Monitor for bleeding, particularly if istradefylline is used at 40 mg daily or in renal impairment. Consider the lower istradefylline dose or an alternative anticoagulant.
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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Rivaroxaban?
MediHelp rates the interaction as moderate. Istradefylline 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. Istradefylline at 40 mg daily increases exposure to CYP3A4 substrates, so it could raise rivaroxaban levels and bleeding risk. At 20 mg daily this effect was not seen.
How serious is the interaction between Istradefylline 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, particularly if istradefylline is used at 40 mg daily or in renal impairment. Consider the lower istradefylline dose or an alternative anticoagulant.
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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