vorapaxar
Brand names: Zontivity
Vorapaxar (Zontivity) helps prevent blood clots if you have had a heart attack or have peripheral artery disease. It works by stopping platelets in your blood from sticking together and forming clots.
What it does
Vorapaxar is used to lower the chance of having serious heart problems if you have a history of heart attack or peripheral artery disease (PAD).
Common side effects
Bleeding
Key warnings
Vorapaxar can cause serious bleeding, including bleeding in the brain, which can be fatal.
How It Works
Vorapaxar is a PAR-1 antagonist, which means it blocks a specific receptor on platelets. This receptor, called protease-activated receptor-1 (PAR-1), normally causes platelets to clump together. By blocking PAR-1, vorapaxar helps prevent blood clots from forming.
How to Take It
Take one 2.08 mg vorapaxar tablet once a day. You can take it with or without food. Vorapaxar should be used with aspirin and/or clopidogrel, as directed by your doctor. Talk to your doctor if you have any questions about how to take vorapaxar.
Pregnancy & Breastfeeding
It is not known if vorapaxar will harm an unborn baby. Talk to your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store the tablets at room temperature (68-77°F) in the original package, tightly closed, and protected from moisture. Keep the desiccant in the bottle.
Serious Warnings
Vorapaxar can cause serious bleeding, including bleeding in the brain, which can be fatal. You should not take this medicine if you have a history of stroke, transient ischemic attack (TIA), or bleeding in the brain. Also, do not take it if you have active bleeding.
Known Drug Interactions
Strong CYP3A Inhibitors Avoid concomitant use of ZONTIVITY with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) [see Warnings and Precautions (5.2) and Clinical Pharmacology (12.3) ] .
Mechanism: Ketoconazole blocks the enzyme that breaks down vorapaxar, which can cause the drug to build up to high levels in your body.
What to do: Do not take these two medications together.
Strong CYP3A Inducers Avoid concomitant use of ZONTIVITY with strong inducers of CYP3A (e.g., rifampin, carbamazepine, St.
Mechanism: Carbamazepine speeds up how fast your body gets rid of vorapaxar, which can make the drug less effective.
What to do: Avoid using these two medicines at the same time.
Strong CYP3A Inhibitors Avoid concomitant use of ZONTIVITY with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) [see Warnings and Precautions (5.2) and Clinical Pharmacology (12.3) ] .
Mechanism: Clarithromycin stops your body from processing vorapaxar correctly, leading to higher amounts of the drug in your blood.
What to do: You should avoid taking these two drugs together.
Strong CYP3A Inducers Avoid concomitant use of ZONTIVITY with strong inducers of CYP3A (e.g., rifampin, carbamazepine, St.
Mechanism: Rifampin causes your body to break down vorapaxar too quickly, which may prevent the medicine from working as it should.
What to do: Do not use these two medications together.
Strong CYP3A Inhibitors Avoid concomitant use of ZONTIVITY with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) [see Warnings and Precautions (5.2) and Clinical Pharmacology (12.3) ] .
Mechanism: Posaconazole interferes with the way your body clears vorapaxar, which can lead to an unsafe buildup of the medication.
What to do: Avoid using this combination of drugs.
Common Questions
Can I take vorapaxar by itself?
What should I do if I notice unusual bleeding?
Can I drink alcohol while taking vorapaxar?
Will vorapaxar stop working right away if I stop taking it?
What if I need surgery?
Can I take other medicines with vorapaxar?
What are the signs of a stroke?
How does vorapaxar affect my risk of bleeding?
What should I do if I am hypotensive after a heart procedure?
Is there a way to reverse the effects of vorapaxar if I bleed?
What are the common side effects of vorapaxar?
Does vorapaxar interact with other medications?
What drug class is vorapaxar?
Is vorapaxar safe during pregnancy?
Related Medications in PAR-1 Antagonist (Antiplatelet)
Other drugs grouped near vorapaxar — same-class peers and common alternatives.
apixaban
Eliquis
Apixaban (Eliquis) is a medicine that helps prevent blood clots.
Compare with vorapaxar →
aspirin
Bayer, Ecotrin
Aspirin is a common medicine used to relieve minor pain.
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cilostazol
Pletal
Cilostazol is a medicine that helps improve walking distance in people with leg pain due to poor circulation.
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clopidogrel
Plavix
Clopidogrel is a drug that helps to prevent blood clots.
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dabigatran
Pradaxa
Dabigatran (Pradaxa) is a drug that helps to prevent blood clots from forming.
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for vorapaxar
The FDA label for vorapaxar (sold under brand names such as Zontivity) classifies it as a prescription-only medication in the PAR-1 Antagonist (Antiplatelet) class. Vorapaxar is used to lower the chance of having serious heart problems if you have a history of heart attack or peripheral artery disease (PAD). Official labeling lists 1 commonly reported side effect, including Bleeding.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. Voluntary reports accumulate over the lifetime of a drug and reflect wide-ranging clinical use. The database also lists 8 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. Acquisition-cost data is surveyed weekly by CMS and updated as manufacturers report changes.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: April 21, 2018
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages