Combined P-gp and strong CYP3A4 inhibitor | Antifungals: posaconazole, itraconazole, ketoconazole Macrolide: clarithromycin | Avoid these medications |
Combined P-gp and/or moderate CYP3A4 inhibitor‡ | Antimicrobials: erythromycin, ciprofloxacin, fluconazole, voriconazole, isoniazid Antidepressants: fluoxetine, fluvoxamine, sertraline Antihypertensives: verapamil, diltiazem Antiarrhythmic: amiodarone Antivirals for HIV: atazanavir, efavirenz, telaprevir | Use these medications with caution; consider a lower dose of rivaroxaban |
Concomitant use of drugs affecting hemostasis | Anti-inflammatory agents: NSAIDs Antiplatelet agents: ASA, clopidogrel, prasugrel, ticagrelor | Use these medications with caution; re-evaluate need for antiplatelet therapy |
Dietary products | Grapefruit juice, dietary quinine | Use these products with caution |
Renal failure | CrCl 30–49 mL/min | Decrease the dose of rivaroxaban (to 15 mg/d) |
CrCl < 30 mL/min | Avoid use of rivaroxaban |
Liver failure | Child–Pugh class B and C | Avoid use of rivaroxaban |