Coleus - Xarelto (Rivaroxaban) Interaction

Interaction Details

Rivaroxaban is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates

In vitro research shows that coleus can activate the nuclear receptor, pregnane X receptor (PXR), which results in increased expression of CYP3A4. Theoretically, coleus might induce CYP3A4 and decrease levels of drugs metabolized by this enzyme. Although the clinical significance of this is not known, use caution when considering concomitant use of coleus and other drugs affected by these enzymes. Drugs that might be affected include some calcium channel blockers (diltiazem, nicardipine, verapamil), chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), glucocorticoids, cisapride (Propulsid), alfentanil (Alfenta), fentanyl (Sublimaze), losartan (Cozaar), fluoxetine (Prozac), midazolam (Versed), omeprazole (Prilosec), ondansetron (Zofran), propranolol (Inderal), fexofenadine (Allegra), and numerous others.

Interaction Rating

Likelihood of Occurrence

Interaction 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

• Ding, X. and Staudinger, J. L. Induction of drug metabolism by forskolin: the role of the pregnane X receptor and the protein kinase a signal transduction pathway. J Pharmacol Exp Ther 2005;312(2):849-856.
• Staudinger, J. L., Ding, X., and Lichti, K. Pregnane X receptor and natural products: beyond drug-drug interactions. Expert.Opin Drug Metab Toxicol 2006;2(6):847-857.

Interaction Details

Rivaroxaban is classified as belonging to the following category: Anticoagulant/Antiplatelet Drugs

There is some evidence forskolin, a constituent of coleus, can inhibit platelet aggregation and adhesion. Theoretically, concomitant use of coleus and anticoagulant or antiplatelet drugs might increase the risk of bruising and bleeding. Some anticoagulant and antiplatelet drugs include abciximab (ReoPro), anagrelide (Agrylin), antithrombin III (Thrombate III), ardeparin (Normiflo), cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), danaparoid (Orgaran), dicumarol, dipyridamole (Persantine), enoxaparin (Lovenox), eptifibatide (Integrilin), heparin, lepirudin (Refludan), tirofiban (Aggrastat), and warfarin (Coumadin).

Interaction Rating

Likelihood of Occurrence

Interaction 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

• Christenson JT, Thulesius O, Nazzal MM. The effect of forskolin on blood flow, platelet metabolism, aggregation and ATP release. Vasa 1995;24:56-61.
• Agarwal KC, Zielinski BA, Maitra RS. Significance of plasma adenosine in the antiplatelet activity of forskolin: potentiation by dipyridamole and dilazep. Thromb Haemost 1989;61:106-10.
• Agarwal KC, Parks RE. Forskolin: a potential antimetastatic agent. Int J Cancer 1983;32:801-4.

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.

Coleus - More Interactions

Coleus interacts with 869 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.