rivaroxaban
2 interactions related to rivaroxaban
rivaroxaban + fish oil
Omega-3 fatty acids in fish oil have a mild antiplatelet effect, slightly shifting platelet thromboxane production and modestly lengthening bleeding time. Rivaroxaban blocks Factor Xa to reduce clotting. The two act through different pathways, so the combination is additive in theory, but clinical evidence suggests the real-world bleeding effect is small. A large randomized trial found no increase in bleeding even with high-dose fish oil.
rivaroxaban + ginkgo
Rivaroxaban is a Factor Xa inhibitor and ginkgo has mild antiplatelet activity, so combining them was theorized to add to bleeding risk. However, a controlled trial in healthy subjects found standardized EGb 761 ginkgo extract did not change rivaroxaban's pharmacokinetics, anti-Factor Xa activity, or coagulation parameters, and caused no bleeding-related adverse events.