Drug Interactions With Rivaroxaban

More Detail on Drug Interactions With Rivaroxaban

The following sections explain in detail the potentially negative interactions that can occur when rivaroxaban is combined with any of the drugs listed above.
 
CYP 3A4 Inducers
Rivaroxaban is broken down (metabolized) by liver enzymes known as CYP 3A4 enzymes. Medications known as CYP 3A4 inducers speed up the activity of these enzymes, lowering the level of rivaroxaban in the body and decreasing its effectiveness. Check with your healthcare provider before combining rivaroxaban with one of these drugs.
 
There is a subset of CYP 3A4 inducers that also speed up the activity of P-glycoprotein (an enzyme that helps remove rivaroxaban from the tissues in the body). If you must take these drugs with rivaroxaban, an increased rivaroxaban dosage may be necessary. In general, these medications should not be combined with rivaroxaban. These medications include carbamazepine, rifampin, phenytoin, and St. John's wort.
 
CYP 3A4 Inhibitors
Rivaroxaban is broken down (metabolized) by liver enzymes known as CYP 3A4 enzymes. Medications known as CYP 3A4 inhibitors slow down the activity of these enzymes, increasing the level of rivaroxaban in the body and increasing the risk for bleeding. Check with your healthcare provider before combining rivaroxaban with one of these drugs. This is important for everyone, but is especially important for people with kidney disease, as studies suggest that this interaction may be even more significant for such individuals.
 
There is a subset of CYP 3A4 inhibitors that also slow down the activity of P-glycoprotein (an enzyme that helps remove rivaroxaban from the tissues in the body). In general, these medications should not be combined with rivaroxaban. These medications include ketoconazole, itraconazole, lopinavir/ritonavir, ritonavir, and conivaptan.
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Rivaroxaban Medication Information

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