Drug interactions
Paroxetine + Rivaroxaban
Severity: Moderate
Paroxetine 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
Paroxetine impairs platelet serotonin uptake and platelet aggregation, which adds to the bleeding tendency of rivaroxaban. The risk of gastrointestinal and other bleeding is increased.
What this interaction means in plain words
Paroxetine 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.
Paroxetine belongs to Central Nervous System; Rivaroxaban belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effect: SSRI-mediated platelet dysfunction plus factor Xa inhibition.
What to do
Monitor for bleeding and anemia, and consider gastroprotection in high-risk patients. Reassess the need for the SSRI 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?
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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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Paroxetine with Rivaroxaban?
MediHelp rates the interaction as moderate. Paroxetine 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. Paroxetine impairs platelet serotonin uptake and platelet aggregation, which adds to the bleeding tendency of rivaroxaban. The risk of gastrointestinal and other bleeding is increased.
How serious is the interaction between Paroxetine 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 and anemia, and consider gastroprotection in high-risk patients. Reassess the need for the SSRI 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.
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