Drug interactions
Rivaroxaban + Valproic acid
Severity: Minor
Rivaroxaban and Valproic acid: minor 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
The legacy suggestion that valproic acid lowers rivaroxaban levels has no well-established mechanism. Valproate can also impair platelet function and cause thrombocytopenia, which may add to bleeding risk.
What this interaction means in plain words
Rivaroxaban and Valproic acid have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Rivaroxaban belongs to Cardiovascular; Valproic acid belongs to Central Nervous System.
Why it happens
No established pharmacokinetic mechanism; valproate may add to bleeding through platelet effects.
What to do
Monitor for bleeding and consider checking platelet counts during long-term combined use.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin / relebactam + Valproic acid Contraindicated
- Imipenem / cilastatin + Valproic acid Contraindicated
- Meropenem / vaborbactam + Valproic acid Contraindicated
- Meropenem + Valproic acid Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Valproic acid Major
Frequently asked questions
Can I take Rivaroxaban with Valproic acid?
MediHelp rates the interaction as minor. Rivaroxaban and Valproic acid have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. The legacy suggestion that valproic acid lowers rivaroxaban levels has no well-established mechanism. Valproate can also impair platelet function and cause thrombocytopenia, which may add to bleeding risk.
How serious is the interaction between Rivaroxaban and Valproic acid?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for bleeding and consider checking platelet counts during long-term combined use.
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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