Drug interactions
Rivaroxaban + Ticlopidine
Severity: Major
Rivaroxaban and Ticlopidine: major 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
Ticlopidine inhibits platelet aggregation and together with rivaroxaban markedly raises the risk of bleeding. Ticlopidine can also cause hematologic toxicity, such as neutropenia and thrombocytopenia, which compounds the risk.
What this interaction means in plain words
Rivaroxaban and Ticlopidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Rivaroxaban belongs to Cardiovascular; Ticlopidine belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effect from P2Y12 platelet inhibition together with factor Xa inhibition.
What to do
Avoid the combination and use clopidogrel or another alternative if antiplatelet therapy is needed. If unavoidable, monitor blood counts and watch for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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 Ticlopidine
Frequently asked questions
Can I take Rivaroxaban with Ticlopidine?
MediHelp rates the interaction as major. Rivaroxaban and Ticlopidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ticlopidine inhibits platelet aggregation and together with rivaroxaban markedly raises the risk of bleeding. Ticlopidine can also cause hematologic toxicity, such as neutropenia and thrombocytopenia, which compounds the risk.
How serious is the interaction between Rivaroxaban and Ticlopidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use clopidogrel or another alternative if antiplatelet therapy is needed. If unavoidable, monitor blood counts and watch for bleeding.
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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