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ketoconazole vs rivaroxaban

Side-by-side comparison of ketoconazole and rivaroxaban. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.

moderate Known Drug Interaction

7.2 Drugs that Inhibit Cytochrome P450 3A Enzymes and Drug Transport Systems Interaction with Combined P-gp and Strong CYP3A Inhibitors Avoid concomitant administration of XARELTO with known combined P-gp and strong CYP3A inhibitors (e.g., ketoconazole and ritonavir) [see Warnings and Precautions (5.6) and Clinical Pharmacology (12.3) ] .

Recommendation: Do not take these two medications together as it can increase your risk of side effects.

Drug Class
ketoconazole Azole Antifungal
rivaroxaban Direct Oral Anticoagulant (Factor Xa Inhibitor)
Type
ketoconazole Over-the-Counter
rivaroxaban Prescription
Summary
ketoconazole

Ketoconazole shampoo is an antifungal medicine. It treats a fungal infection on your skin.

rivaroxaban

Rivaroxaban (Xarelto) is a drug that helps to prevent blood clots from forming. It is used to lower the risk of stroke and treat or prevent dangerous clots in your veins and lungs.

What It Treats
ketoconazole

This shampoo treats tinea versicolor, a fungal infection. This infection can cause patches on your skin that are lighter or darker than the surrounding skin. These patches may appear on your trunk, neck, arms, and upper thighs.

rivaroxaban

This medicine can help prevent strokes in people with an irregular heartbeat called atrial fibrillation. It also treats blood clots in the legs (deep vein thrombosis or DVT) and lungs (pulmonary embolism or PE). Rivaroxaban can also lower the risk of these clots coming back. It is also used to prevent blood clots after hip or knee replacement surgery and in acutely ill patients.

How It Works
ketoconazole

Ketoconazole is an antifungal medicine. It works by stopping the growth of the fungus. This helps to clear up the infection.

rivaroxaban

Rivaroxaban is a factor Xa inhibitor. It blocks a substance in your blood called factor Xa. By blocking factor Xa, the medicine helps to prevent blood clots from forming.

Common Side Effects
ketoconazole

No common side effects listed.

rivaroxaban
  • Bleeding
  • Cough
  • Vomiting
  • Gastroenteritis (inflammation of the stomach and intestines)
FAERS Reports
ketoconazole
  • Feeling tired 929
  • Itching 902
  • Feeling sick to your stomach 834
  • Skin breakout 802
  • Loose stool 760
rivaroxaban
  • Bleeding in the stomach or intestines 21,559
  • Bleeding 7,713
  • Shortness of breath 7,149
  • Nosebleed 6,698
  • Tiredness 6,546
Serious Warnings
ketoconazole

You should not use this shampoo if you are allergic to ketoconazole or any of the other ingredients.

rivaroxaban

This medicine has two important warnings. First, stopping this medicine too early can increase your risk of blood clots. Do not stop taking it without talking to your doctor first. Second, if you receive spinal anesthesia or have a spinal puncture while taking this medicine, you have a risk of a blood clot forming around your spine, which can cause long-term paralysis.

Pregnancy
ketoconazole

It is not known if ketoconazole shampoo can harm an unborn baby. Talk to your doctor if you are pregnant or breastfeeding before using this medicine.

rivaroxaban

Talk to your doctor if you are pregnant or plan to become pregnant. This medicine may cause bleeding problems during pregnancy and delivery. It is not known if this medicine passes into breast milk, so talk to your doctor about the risks and benefits of breastfeeding.

Also Compare, Nearby Drugs

How to Read This ketoconazole vs rivaroxaban Comparison

ketoconazole is classified in the Azole Antifungal drug class, while rivaroxaban sits within the Direct Oral Anticoagulant (Factor Xa Inhibitor) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are split between OTC and prescription status, which affects access and supervision.

Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, ketoconazole has 4,227 submissions while rivaroxaban has 49,665. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to ketoconazole stops your body from breaking down rivaroxaban, which can cause the medicine to build up to unsafe levels.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.

A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between ketoconazole and rivaroxaban - always consult your physician or pharmacist first.

Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.