Drug interactions
Vorapaxar + Warfarin
Severity: Major
Vorapaxar and Warfarin: 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 inhibits platelet aggregation through PAR-1 antagonism, and adding it to warfarin raises the likelihood of clinically significant bleeding, including intracranial hemorrhage. The label advises caution with anticoagulants.
What this interaction means in plain words
Vorapaxar and Warfarin 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 effect: antiplatelet PAR-1 blockade combined with vitamin K antagonist anticoagulation.
What to do
Avoid the combination where possible and do not use vorapaxar in patients with a history of stroke, TIA or intracranial bleeding. If co-prescribed, monitor closely for bleeding and check INR and hemoglobin.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Vorapaxar with Warfarin?
MediHelp rates the interaction as major. Vorapaxar and Warfarin 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 inhibits platelet aggregation through PAR-1 antagonism, and adding it to warfarin raises the likelihood of clinically significant bleeding, including intracranial hemorrhage. The label advises caution with anticoagulants.
How serious is the interaction between Vorapaxar and Warfarin?
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 where possible and do not use vorapaxar in patients with a history of stroke, TIA or intracranial bleeding. If co-prescribed, monitor closely for bleeding and check INR and hemoglobin.
What other medicines interact with Warfarin?
MediHelp also lists interactions of Warfarin with, for example, Defibrotide, Ketorolac, Abciximab. The full list is on the Warfarin page.
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