zontivity
Zontivity (vorapaxar) is an antiplatelet medication used to prevent complications from blood clots in people who've already had a heart attack or people with peripheral artery disease (PAD). It's taken once per day, but it has to be taken with clopidogrel (Plavix), aspirin, or both.
What is Zontivity (vorapaxar)?
What is Zontivity (vorapaxar) used for?
Lowering the risk of serious blood clots in:
People who've already had a heart attack
People with poor blood flow in their legs (peripheral artery disease, PAD)
How Zontivity (vorapaxar) works
Zontivity (vorapaxar) is an antiplatelet medication. Platelets are blood cells that help stop bleeding where you get injured. When they're activated, platelets stick together and form clots to stop bleeding. Sometimes, clots form in your blood vessels that block blood flow to important parts of your body and cause complications, like stroke and heart attack.
Zontivity (vorapaxar) blocks a protein in your blood that prevents platelets from being activated and sticking together. This helps prevent blood clots from forming and lower the risk of complications.
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What are the side effects of Zontivity (vorapaxar)?
Common Side Effects
- Anemia (low blood cell count, 5%)
Other Side Effects
- Depression
- Rash or skin eruptions
Serious Side Effects
- Serious or severe bleeding: bleeding that won't stop, bruises that won't go away, bleeding from your gums, nose bleeds, blood in your urine, bloody or black, tarry stools, coughing up or vomiting blood or "coffee ground" bits, large amount of bleeding, dizziness, lightheadedness, feel like you're going to faint
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Blurry vision, vision loss, seeing wavy or bent objects or blind spots with dark, light, or flashing spots
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Double vision
- Skin rash
- Worsening mood, feelings of depression
Pros and cons of Zontivity (vorapaxar)
Pros
Taken once per day
Can be taken with or without food
Proven to lower the rate of heart complications, heart attack, stroke, and death
Cons
Can't be used alone; must take with clopidogrel (Plavix), aspirin, or both
Can raise your risk of bleeding
Only available as a brand-name medication, which can be expensive
Pharmacist tips for Zontivity (vorapaxar)
Zontivity (vorapaxar) must be taken with either clopidogrel (Plavix), aspirin, or both clopidogrel (Plavix) and aspirin. Don't take Zontivity (vorapaxar) by itself. It's not known if taking this medication alone is safe or if it will work well for you.
Zontivity (vorapaxar) raises your risk of bleeding and bruising. It can make you bleed or bruise more easily, so be careful to avoid injuries. Get medical attention right away if you have bruises that won't go away, bleeding that won't stop (nose bleeds, bleeding from your gums), blood in your urine, or bloody or black, tarry stools, or there's a large amount of blood. Also seek medical help immediately if you have any dizziness, lightheadedness, or feel like you're going to faint with any bleeding or bruising.
Before any surgeries or dental procedures, tell your providers and dentist that you're taking Zontivity (vorapaxar). This medication raises your risk of bleeding, so your providers will need to plan the procedure accordingly to lower your risk of bleeding complications.
Even after stopping Zontivity (vorapaxar), you can still be at risk for bleeding for about 4 more weeks, since the medication stays in your body for a long time. Be sure to watch out for any bleeding or bruising during this time. Also, before any upcoming procedures, let your providers know that you've recently stopped taking Zontivity (vorapaxar).
In general, it's recommended to take acetaminophen (Tylenol) for pain or fever, instead of nonsteriodal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve), while taking Zontivity (vorapaxar). This is because NSAIDs can further raise your risk of bleeding. Ask your provider or pharmacist about medication options for pain or fever.
Zontivity (vorapaxar) interacts with other medications. Make sure to tell your provider about all the medications you're taking before starting Zontivity (vorapaxar). Don't start any new medications while taking Zontivity (vorapaxar) without talking to your provider or pharmacist first.
Frequently asked questions about Zontivity (vorapaxar)
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What are the risks and warnings for Zontivity (vorapaxar)?
Zontivity (vorapaxar) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Bleeding
Risk factors: Older age | Low body weight | Kidney or liver problems | History of bleeding problems | Using other medications that raise your risk of bleeding
Zontivity (vorapaxar) raises your risk of bleeding that can be severe or life-threatening, including bleeding in your head or brain. Even mild bleeding can be dangerous, since Zontivity (vorapaxar) can make it hard for bleeding to stop. Watch out for bruises that won't go away, bleeding that won't stop (e.g., bleeding from your gums, nose bleeds), coughing up or vomiting blood or "coffee ground" bits, blood in your urine, or bloody or black, tarry stools. Get medical attention right away if you experience any of the above signs, especially if there's a large amount of bleeding or if you feel dizzy, lightheaded, or feel like you're going to faint.
While taking Zontivity (vorapaxar), avoid medications that can also raise your risk of bleeding, such as warfarin (Coumadin), Eliquis (apixaban), other anticoagulants, long-term use of NSAIDs, fluoxetine (Prozac), and duloxetine (Cymbalta). Ask your provider about alternative medications you can take in the meantime.
Interactions with other medications
Zontivity (vorapaxar) interacts with other medications. Certain medications, like the antibiotic clarithromycin, can raise Zontivity (vorapaxar) levels in your body and raise your risk of serious bleeding and side effects (e.g., anemia). Other medications, like carbamazepine (Tegretol) and phenytoin (Dilantin) for seizures, can lower Zontivity (vorapaxar) levels in your body and make it not work as well. Make sure to tell your provider about all the medications you're taking, including over-the-counter medications and supplements, before starting Zontivity (vorapaxar). Some medications might need their doses to be adjusted, while others might need to be stopped completely. Don't start any new medications while taking Zontivity (vorapaxar) without talking to your provider or pharmacist first.
Zontivity (vorapaxar) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2.08mg | 30 tablets | $376.00 | $12.53 |
Typical dosing for Zontivity (vorapaxar)
The typical dose is 1 tablet (2.08 mg) by mouth once per day.
How much does Zontivity (vorapaxar) cost?
Zontivity (vorapaxar) contraindications
History of stroke, transient ischemic attack (TIA), or head bleed
Active bleeding (e.g., head bleed, stomach ulcer)
What are alternatives to Zontivity (vorapaxar)?
Lowering the risk of serious blood clots in:
People who've already had a heart attack
People with poor blood flow in their legs (peripheral artery disease, PAD)
Lowering the risk of heart-related death, heart attack, and stroke in people with acute coronary syndrome (ACS) or who've had a previous heart attack
Lowering the risk of a first-time heart attack or stroke in high-risk people with coronary artery disease (CAD)
Lowering the risk of stroke in people who've had a previous stroke or a high-risk transient ischemic attack (TIA) (also called "mini stroke")
Heart attack prevention
Stroke prevention
Zontivity (vorapaxar) images
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