Drug General Information (ID: DDIDRVK17X)
Drug Name			Vorapaxar		Drug Info		Dextran (-1)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiplatelet Agents/Protease-Activated Receptor-1 Antagonists				Plasma Expanders
Structure

Mechanism of Vorapaxar-Dextran (-1) Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Vorapaxar				Dextran (-1)
Mechanism		Risk of bleeding Antiplatelet				Risk of bleeding Anticoagulant effects
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Vorapaxar and Dextran (-1)

Recommended Action
Management		Caution is advised if vorapaxar is used in combination with other drugs that affect hemostasis. Close clinical and laboratory observation for hemorrhagic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References
1	Product Information. Zontivity (vorapaxar). Merck &amp Company Inc, Whitehouse Station, NJ.