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.
Drug facts
Side effects of Zontivity (vorapaxar)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Anemia (low blood cell count, 5%)
Less Common Side Effects
- Depression
- Rash or skin eruptions
Zontivity (vorapaxar) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
The following Zontivity (vorapaxar) 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
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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.
Common questions about Zontivity (vorapaxar)
No. Zontivity (vorapaxar) can only be used with either clopidogrel (Plavix), aspirin, or clopidogrel (Plavix) and aspirin. The FDA approved Zontivity (vorapaxar) to be used this way based on clinical studies with people who were taking either clopidogrel (Plavix), aspirin, or both. It's not known if taking Zontivity (vorapaxar) alone is safe or if it will work well for you.
The purpose of taking Zontivity (vorapaxar) is to lower your risk of heart attack or stroke. But it's still possible to have a heart attack or stroke while taking Zontivity (vorapaxar).
No. There haven't been enough studies looking at how Zontivity (vorapaxar) affects pregnant women and their unborn baby, so it's not known if it's safe to use during pregnancy. Because of the risk of serious maternal bleeding, it's recommended that you stop using Zontivity (vorapaxar) right away if you find out you're pregnant and speak to your provider. Your provider will work with you to find another medication that's safer for you. If you're pregnant or thinking of getting pregnant, talk to your provider about safe and appropriate options for you.
No. We don't know if Zontivity (vorapaxar) is found in breast milk and what effects it could have on your breastfed baby. Because of the medication's serious risk of bleeding, don't take Zontivity (vorapaxar) if you're breastfeeding. Ask your provider about safer options for you.
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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
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2.08mg | 30 tablets | $393.31 | $13.11 |
Typical dosage for Zontivity (vorapaxar)
The typical dose is 1 tablet (2.08 mg) by mouth once per day.
How much does Zontivity (vorapaxar) cost?
$393.31
Zontivity (vorapaxar) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Zontivity (vorapaxar) will not be safe for you to take.
- History of stroke, transient ischemic attack (TIA), or head bleed
- Active bleeding (e.g., head bleed, stomach ulcer)
What are alternatives to Zontivity (vorapaxar)?
For people with a history of a heart attack, stroke, or peripheral artery disease:
