Drug interactions
Rivaroxaban + Tamoxifen
Severity: Moderate
Rivaroxaban and Tamoxifen: 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
Tamoxifen has weak P-glycoprotein and CYP3A4 inhibiting properties and may modestly raise rivaroxaban exposure, especially in renal impairment. Tamoxifen itself also raises the risk of venous thromboembolism, which is often the reason for anticoagulation.
What this interaction means in plain words
Rivaroxaban and Tamoxifen 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.
Rivaroxaban belongs to Cardiovascular; Tamoxifen belongs to Endocrine.
Why it happens
Weak inhibition of P-glycoprotein and CYP3A4 by tamoxifen may reduce rivaroxaban clearance.
What to do
Monitor for bleeding, particularly in patients with reduced renal function. Use in renal impairment only if the benefit outweighs the risk.
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 Tamoxifen
- Amiodarone + Tamoxifen Major
- Anastrozole + Tamoxifen Major
- Bupropion + Tamoxifen Major
- Carbamazepine + Tamoxifen Major
- Cinacalcet + Tamoxifen Major
- Dacomitinib + Tamoxifen Major
Frequently asked questions
Can I take Rivaroxaban with Tamoxifen?
MediHelp rates the interaction as moderate. Rivaroxaban and Tamoxifen 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. Tamoxifen has weak P-glycoprotein and CYP3A4 inhibiting properties and may modestly raise rivaroxaban exposure, especially in renal impairment. Tamoxifen itself also raises the risk of venous thromboembolism, which is often the reason for anticoagulation.
How serious is the interaction between Rivaroxaban and Tamoxifen?
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, particularly in patients with reduced renal function. Use in renal impairment only if the benefit outweighs the risk.
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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