Drug interactions
Ranolazine + Rivaroxaban
Severity: Moderate
Ranolazine 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
Ranolazine is a weak CYP3A4 and P-glycoprotein inhibitor and can modestly raise rivaroxaban exposure. The effect matters most in renal impairment, where both elimination pathways are already compromised and bleeding risk may increase.
What this interaction means in plain words
Ranolazine 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.
Ranolazine belongs to Cardiovascular; Rivaroxaban belongs to Cardiovascular.
Why it happens
Combined inhibition of P-glycoprotein and CYP3A4 by ranolazine reduces rivaroxaban clearance.
What to do
In patients with renal impairment, use together only if benefit outweighs risk and monitor closely for bleeding. Check renal function and hemoglobin periodically.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Other interactions of Rivaroxaban
- Defibrotide + Rivaroxaban Contraindicated
- Ketoconazole + Rivaroxaban Contraindicated
- Ketorolac + Rivaroxaban Contraindicated
- Abciximab + Rivaroxaban Major
- Acalabrutinib + Rivaroxaban Major
- Acetylsalicylic acid + Rivaroxaban Major
Frequently asked questions
Can I take Ranolazine with Rivaroxaban?
MediHelp rates the interaction as moderate. Ranolazine 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. Ranolazine is a weak CYP3A4 and P-glycoprotein inhibitor and can modestly raise rivaroxaban exposure. The effect matters most in renal impairment, where both elimination pathways are already compromised and bleeding risk may increase.
How serious is the interaction between Ranolazine 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: In patients with renal impairment, use together only if benefit outweighs risk and monitor closely for bleeding. Check renal function and hemoglobin periodically.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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