Drug Interaction Report

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 may decrease the plasma concentrations of vorapaxar, which is a substrate of the isoenzyme. When vorapaxar was coadministered with rifampin 600 mg, mean vorapaxar peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by approximately 35% and 50%, respectively.

MANAGEMENT: Concomitant use of vorapaxar with potent CYP450 3A4 inducers should generally be avoided due to the potential for reduced efficacy.

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.