7 known interactions • 4 major • 3 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our Medicine Interaction Checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
Strong CYP3A4 + P-gp inhibitors (ketoconazole, ritonavir, clarithromycin)
Markedly increase rivaroxaban exposure, increasing bleeding risk. Avoid combination.
Strong CYP3A4 + P-gp inducers (rifampin, carbamazepine, phenytoin, St. John's Wort)
Markedly reduce rivaroxaban exposure. Avoid combination — anticoagulant effect lost.
Other anticoagulants (warfarin, heparin, apixaban)
Increased bleeding risk. Avoid concurrent use unless transitioning between agents.
NSAIDs (ibuprofen, naproxen, ketorolac)
Additive bleeding risk through antiplatelet effects. Avoid or use with extreme caution; use GI prophylaxis.
Aspirin
At low doses (81–100 mg): indicated combination for CAD/PAD indication. Higher aspirin doses increase bleeding risk significantly.
Antiplatelet agents (clopidogrel)
Increased bleeding risk. Clinical monitoring required.
Dronedarone, fluconazole
Moderate CYP3A4 and P-gp inhibition; may increase rivaroxaban levels. Use with caution.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Xarelto. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.