Cinchona - Xarelto (Rivaroxaban) Interaction
Herbal: Cinchona
Also Known As: Cinchona calisaya, Arbol de la Quina, Bois aux Fièvres, Calisaya Bark, Cascarilla, China Bark, Chinarinde, Chinarindenbaum, Chininbaum, Cinchonine, Écorce du Pérou, Écorce de Quina, Écorce de Quinquina Rouge, Fever Tree, Fieberrinde, Fieberrindenbaum, Jesuit's Bark
Drug: Rivaroxaban
Brand names:
Xarelto
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Rivaroxaban is classified as belonging to the following category: Anticoagulant/Antiplatelet Drugs
Theoretically, cinchona can increase the drug effects and risk of bleeding with anticoagulant and antiplatelet drugs. There is in vitro evidence that the alkaloids quinine, quinidine, and cinchonine present in cinchona inhibit platelet aggregation.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Shah BH, Nawaz Z, Virani SS, Ali IQ, Saeed SA, Gilani AH.The inhibitory effect of cinchonine on human platelet aggregation due to blockade of calcium influx. Biochem Pharmacol 1998;56:955-60.
Cinchona Overview
Cinchona is a genus of flowering plants belonging to the Rubiaceae family. It contains around 25 different species and is native to the Andes mountains of South America. One of the most well-known species is Cinchona calisaya. The bark of cinchona is a source of quinine, an alkaloid that has been used for centuries to treat malaria. Cinchona bark is also used in traditional medicine for a variety of other ailments, including muscle cramps, restless legs, fever, arthritis, and digestive disorders. As Cinchona contains quinine, it is sometimes used as a flavoring on tonic water and alcoholic drinks. Cinchona bark has been shown to contain, on average, 5% to 15% quinoline alkaloids.
Rivaroxaban Overview
-
Rivaroxaban is used to treat deep vein thrombosis (DVT; a blood clot, usually in the leg) and pulmonary embolism (PE; a blood clot in the lung) in adults. Rivaroxaban is also used to prevent DVT and PE from happening again after initial treatment is completed in adults. It is also used to help prevent strokes or serious blood clots in adults who have atrial fibrillation (a condition in which the heart beats irregularly, increasing the chance of clots forming in the body, and possibly causing strokes) that is not caused by heart valve disease. Rivaroxaban is also used to prevent DVT and PE in adults who are having hip replacement or knee replacement surgery or in people who are hospitalized for serious illnesses and are at risk of developing a clot due to decreased ability to move around or other risk factors. It is also used along with aspirin to lower the risk of a heart attack, stroke, or death in adults with coronary artery disease (narrowing of the blood vessels that supply blood to the heart) or peripheral arterial disease (poor circulation in the blood vessels that supply blood to the arms and legs). Rivaroxaban is also used to treat and prevent DVT and PE from happening again in children and certain infants who have received at least 5 days of initial anticoagulation (blood thinner) treatment. It is also used to prevent DVT and PE after heart surgery in children 2 years of age or older who have congenital heart disease (abnormality in the heart that develops before birth). Rivaroxaban is in a class of medications called factor Xa inhibitors. It works by blocking the action of a certain natural substance that helps blood clots to form.
Cinchona - More Interactions
Cinchona interacts with 481 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
Return to the main herbal interaction checker page
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
Ask A Pharmacist About Your Herbal Questions!
Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
Ask A Pharmacist