Abrocitinib and Vorapaxar: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 10, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Vorapaxar
Abrocitinib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Vorapaxar (Zontivity) is a blood thinner that keeps your platelets from sticking together and forming clots. Abrocitinib (Cibinqo) is used for eczema, and during the first few months of treatment it can lower your platelet count. When you take both, the effects add up and your blood may not clot the way it should, which raises your risk of bleeding.
Because of this, taking these two together is not recommended, especially early in abrocitinib treatment. The good news is your care team knows about this and can help. Please don't stop or change either medicine on your own. Talk with your pharmacist or doctor so they can pick the safest plan for you.
Interaction: Additive impairment of hemostasis. Vorapaxar is a PAR-1 antagonist antiplatelet agent; abrocitinib (JAK1 inhibitor) can cause thrombocytopenia, particularly during the first 3 months of therapy. Combined use increases bleeding risk (pharmacodynamic, not PK/enzyme-based).
- Direction: Additive antiplatelet/hemostatic effect, increased bleeding.
- Severity: Contraindicated per labeling.
- Evidence: Theoretical (additive PD).
- Onset: Unspecified; risk concentrated in first 3 months of abrocitinib.
Management: Coadministration of abrocitinib with antiplatelet agents other than low-dose aspirin (81 mg/day or less) is contraindicated during the first 3 months. Prescriber should select an alternative or defer. Monitor platelets and for bleeding signs if therapy overlaps.
What happens
Increased risk of bleeding
Interaction Deep Dive
Giving abrocitinib together with antiplatelet drugs is contraindicated throughout the initial 3 months of therapy because of a heightened bleeding risk, with the exception of low-dose aspirin (no more than 81 mg per day)1.
Why it happens (mechanism)
Additive effects on hemostasis
How to manage this interaction
This combination is flagged as one to avoid during the first 3 months of abrocitinib, so your care team will likely make a plan rather than run both together.
- Keep taking both as prescribed until you speak with your prescriber or pharmacist. Do not stop either drug on your own.
- Your team may choose an alternative or adjust timing so the two are not overlapped early in treatment.
- Watch for and report bleeding signs: unusual bruising, nosebleeds, bleeding gums, blood in urine or stool, or dark/tarry stools.
Note: low-dose aspirin (81 mg daily or less) is the one antiplatelet exception, but any change should come from your care team.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abrocitinib and Vorapaxar together?
Vorapaxar plus abrocitinib adds up to a higher bleeding risk and is considered contraindicated in the first 3 months of abrocitinib, so contact your prescriber or pharmacist before combining them and do not stop either drug on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abrocitinib and Vorapaxar interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abrocitinib and Vorapaxar interaction managed?
This combination is flagged as one to avoid during the first 3 months of abrocitinib, so your care team will likely make a plan rather than run both together. Keep taking both as prescribed until you speak with your prescriber or pharmacist. Do not stop either drug on your own. Your team may choose an alternative or adjust timing so the two are not overlapped early in treatment. Watch for and repo… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abrocitinib or Vorapaxar need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: CIBINQO(TM) oral tablets, abrocitinib oral tablets. Pfizer Labs (per FDA), New York, NY, 2022. DailyMed
Keep reading about Vorapaxar
Keep reading about Abrocitinib
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