Drug interactions
Levetiracetam + Rivaroxaban
Severity: Moderate
Levetiracetam 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
Case reports suggest levetiracetam may lower rivaroxaban levels, possibly via P-gp induction, although evidence is weak. Reduced anticoagulant effect is the concern.
What this interaction means in plain words
Levetiracetam 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.
Levetiracetam belongs to Central Nervous System; Rivaroxaban belongs to Cardiovascular.
Why it happens
Proposed P-glycoprotein induction by levetiracetam; the mechanism is not firmly established.
What to do
Monitor for thromboembolic events; consider rivaroxaban anti-Xa levels or an alternative anticoagulant 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 Levetiracetam
Frequently asked questions
Can I take Levetiracetam with Rivaroxaban?
MediHelp rates the interaction as moderate. Levetiracetam 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. Case reports suggest levetiracetam may lower rivaroxaban levels, possibly via P-gp induction, although evidence is weak. Reduced anticoagulant effect is the concern.
How serious is the interaction between Levetiracetam 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 thromboembolic events; consider rivaroxaban anti-Xa levels or an alternative anticoagulant 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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