Drug interactions
Rivaroxaban + Vorapaxar
Severity: Major
Rivaroxaban and Vorapaxar: 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
Vorapaxar is a platelet protease-activated receptor-1 antagonist, and adding an anticoagulant increases bleeding risk including intracranial hemorrhage. Together they impair both platelet and coagulation pathways.
What this interaction means in plain words
Rivaroxaban and Vorapaxar 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.
Why it happens
Additive pharmacodynamic effects from platelet inhibition and factor Xa inhibition.
What to do
Avoid unless the benefit clearly outweighs bleeding risk; if used, monitor closely for bleeding. Vorapaxar is contraindicated with prior stroke, TIA or intracranial hemorrhage.
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
Frequently asked questions
Can I take Rivaroxaban with Vorapaxar?
MediHelp rates the interaction as major. Rivaroxaban and Vorapaxar 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. Vorapaxar is a platelet protease-activated receptor-1 antagonist, and adding an anticoagulant increases bleeding risk including intracranial hemorrhage. Together they impair both platelet and coagulation pathways.
How serious is the interaction between Rivaroxaban and Vorapaxar?
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 unless the benefit clearly outweighs bleeding risk; if used, monitor closely for bleeding. Vorapaxar is contraindicated with prior stroke, TIA or intracranial hemorrhage.
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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