Phenobarbital and Rivaroxaban: Drug Interaction Guide

Quick answer: This is a major interaction — avoid combining Phenobarbital and Rivaroxaban unless specifically directed by your doctor.

Interaction severity: Major — avoid combination

How Phenobarbital interacts with Rivaroxaban

Phenobarbital induces CYP3A4 and P-glycoprotein, both involved in rivaroxaban disposition. This can lower rivaroxaban exposure and increase thromboembolic risk.

What you should do

Avoid coadministration. Consider warfarin with INR monitoring or another anticoagulant strategy not compromised by enzyme induction.

Key facts

Severity

Major — avoid combination

Mechanism

Phenobarbital induces CYP3A4 and P-glycoprotein, both involved in rivaroxaban disposition. This can lower rivaroxaban ex...

Action

Avoid coadministration. Consider warfarin with INR monitoring or another anticoagulant strategy not compromised by enzym...

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Phenobarbital and Rivaroxaban together?

No — this combination should generally be avoided. Avoid coadministration. Consider warfarin with INR monitoring or another anticoagulant strategy not compromised by enzyme induction.

What is the severity of this interaction?

The interaction between Phenobarbital and Rivaroxaban is classified as Major — avoid combination. Phenobarbital induces CYP3A4 and P-glycoprotein, both involved in rivaroxaban disposition. This can lower rivaroxaban exposure and increase thromboembolic risk.

What should I do if I'm prescribed both?

Avoid coadministration. Consider warfarin with INR monitoring or another anticoagulant strategy not compromised by enzyme induction. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.