Betrixaban; Dabigatran/P-gp Inhibitors that Cause Bleeding Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Your medicine may increase the amount of betrixaban or dabigatran that your body absorbs.Betrixaban, dabigatran, fluvoxamine, ibrutinib, mifepristone all affect how your body stops bleeding.

What might happen:

If you take these medicines together, you may have a higher risk of bleeding.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Let your doctor know right away if you have any signs of bleeding such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Viibryd (vilazodone hydrochloride) US prescribing information. Forest Laboratories Inc. October, 2023.
  • 2.Imbruvica (ibrutinib) US Prescribing information. Pharmacyclics, Inc. August, 2022.
  • 3.Kamel S, Horton L, Ysebaert L, Levade M, Burbury K, Tan S, Cole-Sinclair M, Reynolds J, Filshie R, Schischka S, Khot A, Sandhu S, Keating MJ, Nandurkar H, Tam CS. Ibrutinib inhibits collagen-mediated but not ADP-mediated platelet aggregation. Leukemia 2015 Apr;29(4):783-7.
  • 4.Levade M, David E, Garcia C, Laurent PA, Cadot S, Michallet AS, Bordet JC, Tam C, Sie P, Ysebaert L, Payrastre B. Ibrutinib treatment affects collagen and von Willebrand factor-dependent platelet functions. Blood 2014 Dec 18;124(26):3991-5.
  • 5.Korlym (mifepristone) US Prescribing Information. Corcept Therapeutics November, 2019.
  • 6.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
  • 7.Iwagami M, Tomlinson LA, Mansfield KE, Douglas IJ, Smeeth L, Nitsch D. Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study. Br J Clin Pharmacol 2018 Sep;84(9):2142-2151.
  • 8.Bevyxxa (betrixaban) US prescribing information. Portola Pharmaceuticals, Inc. July, 2019.
  • 9.Pradaxa (dabigatran etexilate mesylate) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. June, 2021.
  • 10.FDA (US Food and Drug Administration). CDER application number. 208383 Bevyxxa Medical Review. acessed at: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/208383Orig1s000Me dR.pdf June 23, 2017.
  • 11.FDA (US Food and Drug Administration). CDER application number. 208383 Bevyxxa Clinical Pharmacology and Biopharmaceuticals Review. accessed at: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2017/208383orig1s000na mer.pdf June 23, 2017.
  • 12.Wiggins BS, Dixon DL, Neyens RR, Page RL 2nd, Gluckman TJ. Select Drug-Drug Interactions With Direct Oral Anticoagulants: JACC Review Topic of the Week..
  • 13.Anonymous. FDA Dabigatran background package for Cardio-Renal Advisory Committee. available at http://wayback.archive-it.org/7993/20170405212218/https://www.fda.gov/dow nloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/Cardiovascular andRenalDrugsAdvisoryCommittee/UCM247244.pdf September 20, 2010.
  • 14.Vosevi (sofosbuvir/velpatasvir/voxilaprevir) US prescribing information. Gilead Sciences, Inc. September, 2019.
  • 15.Mavyret (glecaprevir and pibrentasvir) US prescribing information. AbbVie Inc. October, 2023.
  • 16.Pham P, Schmidt S, Lesko L, Lip GYH, Brown JD. Association of Oral Anticoagulants and Verapamil or Diltiazem With Adverse Bleeding Events in Patients With Nonvalvular Atrial Fibrillation and Normal Kidney Function. JAMA Netw Open;3(4)(2574-3805 (Electronic). 2574-3805 (Linking)):.
  • 17.Hill K, Sucha E, Rhodes E, Carrier M, Garg AX, Harel Z, Hundemer GL, Clark EG, Knoll G, McArthur E, Sood MM. Risk of Hospitalization With Hemorrhage Among Older Adults Taking Clarithromycin vs Azithromycin and Direct Oral Anticoagulants..
  • 18.Dalton SO, Johansen C, Mellemkjaer L, Norgard B, Sorensen HT, Olsen JH. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med 2003 Jan 13;163(1):59-64.
  • 19.de Abajo FJ, Rodriguez LA, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case-control study. BMJ 1999 Oct 23;319(7217):1106-9.
  • 20.Schalekamp T, Klungel OH, Souverein PC, de Boer A. Increased bleeding risk with concurrent use of selective serotonin reuptake inhibitors and coumarins. Arch Intern Med 2008 Jan 28;168(2):180-5.
  • 21.Labos C, Dasgupta K, Nedjar H, Turecki G, Rahme E. Risk of bleeding associated with combined use of selective serotonin reuptake inhibitors and antiplatelet therapy following acute myocardial infarction. CMAJ 2011 Nov 8;183(16):1835-43.
  • 22.Teichert M, Visser LE, Uitterlinden AG, Hofman A, Buhre PJ, Straus S, De Smet PA, Stricker BH. Selective serotonin reuptake inhibiting antidepressants and the risk of overanticoagulation during acenocoumarol maintenance treatment. Br J Clin Pharmacol 2011 May 4.
  • 23.Zhou M, Leonard CE, Brensinger CM, Bilker WB, Kimmel SE, Hecht TEH, Hennessy S. Pharmacoepidemiologic Screening of Potential Oral Anticoagulant Drug Interactions Leading to Thromboembolic Events. Clin Pharmacol Ther 2020 Aug;108(2):377-386.
  • 24.Wang ML, Blum KA, Martin P, Goy A, Auer R, Kahl BS, Jurczak W, Advani RH, Romaguera JE, Williams ME. Long-term follow-up of MCL patients treated with single-agent ibrutinib: updated safety and efficacy results. Blood 2015 Aug 6;126(6):739-45.
  • 25.Mock J, Kunk PR, Palkimas S, Sen JM, Devitt M, Horton B, Portell CA, Williams ME, Maitland H. Risk of Major Bleeding with Ibrutinib. Clin Lymphoma Myeloma Leuk 2018 Nov;18(11):755-761.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.