Vorapaxar

Vorapaxar is a prescription medication used to reduce the risk of heart attack, stroke, cardiovascular death, and need for procedures to restore the blood flow to the heart in patients with a previous heart attack or blockages in the arteries to the legs.

Vorapaxar belongs to a group of drugs called protease-activated receptor-1 (PAR-1) antagonist. It is an anti-platelet agent, designed to decrease the tendency of platelets to clump together to form a blood clot.

This medication comes in tablet form and is taken once a day, with or without food.

Common side effects of vorapaxar include bleeding, including life-threatening and fatal bleeding, anemia, depression, and rash.

Vorapaxar is a prescription medication used to reduce the risk of heart attack, stroke, cardiovascular death, and need for procedures to restore the blood flow to the heart in patients with a previous heart attack or blockages in the arteries to the legs.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Vorapaxar may be found in some form under the following brand names:

• Zontivity

Serious side effects have been reported with vorapaxar. See the “Vorapaxar Precautions” section.

Common side effects of vorapaxar include the following:

• Bleeding, including life-threatening and fatal bleeding
• Anemia
• Depression
• Rashes

This is not a complete list of vorapaxar side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• medications that block a protein in the body (CYPA4) such as some macrolide antibiotics (clarithromycin, telithromycin), some HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir), some HCV protease inhibitors (boceprevir, telaprevir), some azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole), conivaptan (Vaprisol), delavirdine (Rescriptor), and nefazodone
• medications that increase the activity of the enzyme CYP3A4 such as carbamazepine (Tegretol, Equetro, Carbatrol), phenobarbital, phenytoin (Dilantin), rifampin (Rifadin), St John's wort, and nimodipine (Nimotop)

This is not a complete list of vorapaxar drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with vorapaxar including the following:

• Bleeding. Tell your healthcare provider right away if you have any unanticipated, prolonged or excessive bleeding, or blood in their stool or urine.

Do not take vorapaxar if you:

• are allergic to Vorapaxar or to any of its ingredients
• have a history of stroke, transient ischemic attack (TIA), or intracranial hemorrhage ( ICH)
• have active pathologic bleeding

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of vorapaxar, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking vorapaxar, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to vorapaxar or to any of its ingredients
• have a history of stroke, transient ischemic attack (TIA), or intracranial hemorrhage (ICH)
• have active pathologic bleeding
• have reduced kidney or liver function
• have a history of bleeding disorders
• use of certain concomitant medications (e.g., anticoagulants, fibrinolytic therapy, chronic nonsteroidal anti-inflammatory drugs [NSAIDS], selective serotonin reuptake inhibitors, serotonin norepinephrine)

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Vorapaxar falls into category B. There are no well-done studies that have been done in humans with vorapaxar. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if vorapaxar crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using vorapaxar.

Take vorapaxar exactly as prescribed.

Vorapaxar comes in tablet form and is taken once daily, with or without food.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of vorapaxar at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dose of vorapaxar is 2.08 mg once daily.

If you take too much vorapaxar, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store vorapaxar at 20-25°C (68-77°F).
• Keep this and all medicines out of the reach of children.

Warning: Bleeding Risk

Do not use vorapaxar in patients with a history of stroke, transient ischemic attack (TIA), or intracranial hemorrhage (ICH); or active pathological bleeding. 

Antiplatelet agents, including vorapaxar, increase the risk of bleeding, including intracranial hemorrhage (ICH) and fatal bleeding.