Drug interactions
Nintedanib + Rivaroxaban
Severity: Moderate
Nintedanib 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
Nintedanib inhibits VEGF receptors and has been associated with an increased tendency to bleed. Used with a full-dose anticoagulant such as rivaroxaban, the chance of clinically significant hemorrhage is higher.
What this interaction means in plain words
Nintedanib 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.
Nintedanib belongs to Oncology; Rivaroxaban belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effect on bleeding through VEGFR inhibition together with factor Xa inhibition.
What to do
Use only when the benefit justifies it and monitor closely for bleeding, with periodic hemoglobin checks. Adjust or stop therapy if bleeding occurs.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Nintedanib and Rivaroxaban, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Nintedanib
- Amiodarone + Nintedanib Moderate
- Apixaban + Nintedanib Moderate
- Argatroban + Nintedanib Moderate
- Azithromycin + Nintedanib Moderate
- Carbamazepine + Nintedanib Moderate
- Carvedilol + Nintedanib Moderate
Frequently asked questions
Can I take Nintedanib with Rivaroxaban?
MediHelp rates the interaction as moderate. Nintedanib 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. Nintedanib inhibits VEGF receptors and has been associated with an increased tendency to bleed. Used with a full-dose anticoagulant such as rivaroxaban, the chance of clinically significant hemorrhage is higher.
How serious is the interaction between Nintedanib 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: Use only when the benefit justifies it and monitor closely for bleeding, with periodic hemoglobin checks. Adjust or stop therapy if bleeding occurs.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
