Pronunciation: VOR a PAX ar

Brand: Zontivity

What is the most important information I should know about vorapaxar?

You should not use vorapaxar if you have active bleeding, stomach or intestinal bleeding, a head injury, or if you have a history of stroke (including "mini-stroke"), bleeding in your brain, or increased pressure inside the skull.

Vorapaxar increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bloody or tarry stools, red or brown urine, any bleeding that will not stop, or if you cough up blood or vomit that looks like coffee grounds.

What is vorapaxar?

Vorapaxar helps to prevent platelets in your blood from sticking together and forming a blood clot. An unwanted blood clot can occur with certain heart or blood vessel conditions.

Vorapaxar is used to lower the risk of stroke or serious heart problems in people who have had a heart attack or a blood vessel disorder affecting circulation in the arms and legs.

Vorapaxar is sometimes used together with aspirin or clopidogrel (Plavix).

Vorapaxar may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking vorapaxar?

You should not use vorapaxar if you are allergic to it, or if you have:

  • active bleeding;
  • stomach or intestinal bleeding;
  • a head injury or bleeding in your head;
  • a history of stroke;
  • a history of transient ischemic attack (TIA) or "mini-stroke"; or
  • a history of bleeding in your brain or increased pressure inside the skull.

Vorapaxar increases your risk of bleeding, which can be severe or life-threatening, especially if:

  • you have a bleeding or blood clotting disorder such as hemophilia;
  • you are an older adult;
  • you are underweight;
  • you have liver or kidney disease;
  • you take a blood thinner (warfarin, Coumadin, Jantoven);
  • you take certain antidepressants (Celexa, Paxil, Prozac, Zoloft, Cymbalta, Effexor, and others); or
  • you take an NSAID (nonsteroidal anti-inflammatory drug) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

To make sure vorapaxar is safe for you, tell your doctor if you have recently had any heart procedures, such as:

  • heart bypass surgery (coronary artery bypass graft, or CABG);
  • angioplasty (a catheter is inserted to place a "stent" in a blood vessel to open up a blocked or narrowed artery); or
  • coronary angiography (a special dye is injected into a blood vessel that allows your coronary arteries to be easily seen on an x-ray).

This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether vorapaxar passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How should I take vorapaxar?

Vorapaxar is usually taken once per day. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

You may take vorapaxar with or without food.

You may also need to take aspirin or clopidogrel (Plavix). Follow your doctor's instructions very carefully.

If you need surgery or any dental work, tell the surgeon or dentist ahead of time that you are using vorapaxar. You may need to stop using the medicine for a short time to prevent bleeding.

Do not stop using vorapaxar without your doctor's advice. Stopping suddenly may make your condition worse.

Vorapaxar can have long lasting effects in your body. You may still bleed more easily for as long as 4 weeks after you stop using this medicine.

Store at room temperature away from moisture and heat. Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking vorapaxar?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What are the possible side effects of vorapaxar?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;
  • easy bruising or bleeding (nosebleeds, bleeding gums);
  • red or brown urine, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • any bleeding that will not stop;
  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or
  • signs of a stroke --sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

Common side effects may include:

  • bleeding;
  • depression; or
  • rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect vorapaxar?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • imatinib;
  • nefazodone;
  • St. John's wort;
  • an antibiotic --clarithromycin, telithromycin;
  • antifungal medicine --itraconazole, ketoconazole, posaconazole, voriconazole;
  • heart or blood pressure medicine --nicardipine, quinidine;
  • antiviral medicine to treat hepatitis or HIV/AIDS --atazanavir, boceprevir, cobicistat, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir, telaprevir;
  • seizure medicine --carbamazepine, phenytoin; or
  • tuberculosis medicine --isoniazid, rifampin.

Other drugs may interact with vorapaxar, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about vorapaxar.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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