Drug interactions
Rivaroxaban + Verapamil
Severity: Moderate
Rivaroxaban and Verapamil: 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
Verapamil increases rivaroxaban exposure, which can raise bleeding risk. The effect is larger in patients with renal impairment, where both elimination pathways are already reduced.
What this interaction means in plain words
Rivaroxaban and Verapamil 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; Verapamil belongs to Cardiovascular.
Why it happens
Verapamil inhibits intestinal and hepatic CYP3A4 and P-glycoprotein, reducing rivaroxaban clearance.
What to do
Monitor for signs of bleeding, especially in renal impairment. Avoid or reassess the combination if creatinine clearance is markedly reduced.
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 Verapamil
- Dofetilide + Verapamil Contraindicated
- Flibanserin + Verapamil Contraindicated
- Lomitapide + Verapamil Contraindicated
- Lonafarnib + Verapamil Contraindicated
- Pimozide + Verapamil Contraindicated
- Acebutolol + Verapamil Major
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 Rivaroxaban with Verapamil?
MediHelp rates the interaction as moderate. Rivaroxaban and Verapamil 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. Verapamil increases rivaroxaban exposure, which can raise bleeding risk. The effect is larger in patients with renal impairment, where both elimination pathways are already reduced.
How serious is the interaction between Rivaroxaban and Verapamil?
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 signs of bleeding, especially in renal impairment. Avoid or reassess the combination if creatinine clearance is markedly reduced.
What other medicines interact with Verapamil?
MediHelp also lists interactions of Verapamil with, for example, Dofetilide, Flibanserin, Lomitapide. The full list is on the Verapamil page.
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