Drug Interaction Report

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of vorapaxar, which is a substrate of the isoenzyme. When vorapaxar was coadministered with ketoconazole 400 mg, mean vorapaxar peak plasma concentration (Cmax) and systemic exposure (AUC) increased by nearly 2-fold.

MANAGEMENT: Concomitant use of vorapaxar with potent CYP450 3A4 inhibitors should generally be avoided. Some authorities recommend avoiding concomitant use of vorapaxar during and for 2 weeks after treatment with itraconazole.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.