Drug interactions
Letermovir + Rivaroxaban
Severity: Moderate
Letermovir 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
Letermovir moderately inhibits CYP3A4 and affects transporters, which may increase rivaroxaban exposure. This could increase the risk of bleeding, particularly in renal impairment.
What this interaction means in plain words
Letermovir 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.
Letermovir belongs to Anti Virals; Rivaroxaban belongs to Cardiovascular.
Why it happens
Moderate CYP3A4 inhibition (and transporter effects) reduces rivaroxaban clearance.
What to do
Monitor for bleeding signs and renal function during co-therapy. Consider an alternative anticoagulant if bleeding risk is high.
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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Letermovir with Rivaroxaban?
MediHelp rates the interaction as moderate. Letermovir 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. Letermovir moderately inhibits CYP3A4 and affects transporters, which may increase rivaroxaban exposure. This could increase the risk of bleeding, particularly in renal impairment.
How serious is the interaction between Letermovir 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 and renal function during co-therapy. Consider an alternative anticoagulant if bleeding risk is high.
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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