Rivaroxaban and Ketoconazole Interaction
Drug interaction information between Rivaroxaban and Ketoconazole.
Rivaroxaban and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Rivaroxaban and Ketoconazole. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Ketoconazole stops your body from breaking down rivaroxaban, which can cause the medicine to build up to unsafe levels.
FDA Label Information
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) ] .
Rivaroxaban Also Interacts With
- Clopidogrel moderate
- Aspirin moderate
- Warfarin moderate
- Carbamazepine moderate
- Erythromycin moderate
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Frequently Asked Questions
What SPL severity band is on file for Rivaroxaban + Ketoconazole?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Ketoconazole has 113 labeled pairs on file vs Rivaroxaban's 14. In the moderate band specifically: Rivaroxaban has 13 (also Clopidogrel, Aspirin, Warfarin, Carbamazepine); Ketoconazole has 22 (also Alprazolam, Aprepitant, Budesonide/Formoterol, Dexamethasone).
What mechanism field is on file for Rivaroxaban and Ketoconazole?
Ketoconazole stops your body from breaking down rivaroxaban, which can cause the medicine to build up to unsafe levels.
Ketoconazole carries more major-labeled pairs than Rivaroxaban
SPL source-record counts only. This page's band is moderate · classes on file: Rivaroxaban (Direct Oral Anticoagulant (Factor Xa Inhibitor)); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Rivaroxaban's 0. This page itself is in the moderate band, not the major band.
0 major · 13 moderate · 1 minor · 14 total
- Other moderate peers for Rivaroxaban
- Clopidogrel
- Aspirin
- Warfarin
- Carbamazepine
6 major · 22 moderate · 85 minor · 113 total
- Other moderate peers for Ketoconazole
- Alprazolam
- Aprepitant
- Budesonide/Formoterol
- Dexamethasone
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.