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Database of Antiretroviral Drug Interactions

Interactions with Rivaroxaban and Antiretrovirals

Antiretroviral (ARV)Dose of ARVDose of RivaroxabanEffect on ARV LevelsEffect on Rivaroxaban LevelsPotential Clinical EffectsMechanism of InteractionManagement
Atazanavir727
(ATV)(Reyataz)
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

Darunavir727
(DRV)(Prezista)
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

Elvitegravir/cobicistat703
(Genvoya, Stribild)
--- Not studied; may increase rivaroxaban levels Potential for increased risk of bleeding Inhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Elvitegravir/ritonavir-boosted protease inhibitor703
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; use alternative anticoagulant

Fosamprenavir727
(FPV)(Lexiva)
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

Antiretroviral (ARV)Dose of ARVDose of RivaroxabanEffect on ARV LevelsEffect on Rivaroxaban LevelsPotential Clinical EffectsMechanism of InteractionManagement
Lopinavir/ritonavir727
(LPV/r)(Kaletra)
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

Ritonavir727
(RTV)(Norvir)
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

Saquinavir727
(SQV)(Fortovase, Invirase)
---Not studied; may increase rivaroxaban levelsPotential for increased risk of bleedingInhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

Tipranavir727
(TPV)(Aptivus)
--- Not studied; may increase rivaroxaban levels Potential for increased risk of bleeding Inhibition of rivaroxaban metabolism via CYP3A4

Avoid concomitant use; consider alternative anticoagulant

Alternative Agents:
dabigatran

"-" indicates that there are no data available
 703:Tybost [package insert]. Foster City, CA: Gilead Sciences, November 2015.
 727:Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/AdultandAdolescentGL.pdf.