Drug General Information (ID: DDIPLM38W0)
Drug Name			Omacetaxine mepesuccinate		Drug Info		Rivaroxaban		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Anticoagulants/Factor Xa Inhibitors
Structure

Mechanism of Omacetaxine mepesuccinate-Rivaroxaban Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Omacetaxine mepesuccinate				Rivaroxaban
Mechanism		Risk of bleeding Antiplatelet effects				Risk of bleeding Anticoagulant
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 Omacetaxine mepesuccinate and Rivaroxaban

Recommended Action
Management		Concomitant use of other medications that interfere with platelet function or coagulation should be avoided if the patient's platelet count is less than 50,000 per microliter. Close clinical and laboratory observation for bleeding complications is recommended during therapy. The CBC and platelet count should be monitored according to the manufacturer's recommendations.

References
1	Product Information. Brukinsa (zanubrutinib). BeiGene USA, Inc, San Mateo, CA.
2	Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.