Drug Interaction Report

GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 or dual P-glycoprotein (P-gp) and potent CYP450 3A4 inducers may significantly decrease the plasma concentrations of rivaroxaban, which is a substrate of the isoenzyme and of the efflux transporter. In a pharmacokinetic study, administration of a single 20 mg dose of rivaroxaban with the dual P-gp and potent CYP450 3A4 inducer rifampin (titrated up to 600 mg once daily) resulted in approximately 22% and 50% decreases in mean rivaroxaban peak plasma concentration (Cmax) and system exposure (AUC), respectively, with parallel decreases in its pharmacodynamic effects.

MANAGEMENT: Concomitant use of rivaroxaban with potent CYP450 3A4 inducers or dual P-gp and potent CYP450 3A4 inducers should generally be avoided.