Clopidogrel and Rivaroxaban: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clopidogrel
Rivaroxaban
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.
What happens
An increased risk of bleeding
Interaction Deep Dive
Avoid concurrent use of rivaroxaban (factor Xa inhibitor, anticoagulant) with antiplatelets, such as clopidogrel due to the increased risk of bleeding, unless the benefit outweighs the risk. Discontinue rivaroxaban in patients with active pathological bleeding. Promptly evaluate any signs or symptoms of blood loss if patients are treated concomitantly with clopidogrel. In two drug interaction studies where clopidogrel 300 mg loading dose followed by 75 mg daily maintenance dose and rivaroxaban 15 mg single dose were coadministered in healthy subjects, an increase in bleeding time to 45 minutes was observed in approximately 45% and 30% of subjects in these studies, respectively. The change in bleeding time was approximately twice the maximum increase seen with either drug alone. There was no change in the pharmacokinetics of either drug1.
Why it happens (mechanism)
Additive effects on hemostasis
Literature reports
1 report — tap to read
a) In two drug interaction studies where clopidogrel (antiplatelet agent) 300 mg loading dose followed by 75 mg daily maintenance dose and rivaroxaban (factor Xa inhibitor, anticoagulant) 15 mg single dose were coadministered in healthy subjects, an increase in bleeding time to 45 minutes was observed in approximately 45% and 30% of subjects in these studies, respectively. The change in bleeding time was approximately twice the maximum increase seen with either drug alone. There was no change in the pharmacokinetics of either drug 1.
Common questions
Can I take Clopidogrel and Rivaroxaban together?
An increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clopidogrel and Rivaroxaban interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Clopidogrel or Rivaroxaban 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: XARELTO(R) oral tablets, oral suspension, rivaroxaban oral tablets, oral suspension. Janssen Pharmaceuticals Inc (per FDA), Titusville, NJ, 2023. DailyMed
Keep reading about Clopidogrel
Keep reading about Rivaroxaban
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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