Drug Interaction Report

MONITOR CLOSELY: Concomitant use of vorapaxar with other agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents, dextran, nonsteroidal anti-inflammatory agents (chronic), or agents that commonly cause thrombocytopenia may increase the risk of bleeding.

MANAGEMENT: Caution is advised if vorapaxar is used in combination with other drugs that affect hemostasis. Close clinical and laboratory observation for hemorrhagic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.