II. Mechanism
- Protease-Activated Receptor-1 Antagonist (PAR-1 Antagonist)
- Inhibits Platelet aggregation for 4 weeks after dose
III. Indications
- Thrombotic event prevention in patients with significant cardiovascular history
- Not intended to be used alone
- Limited to patients with very high Cardiovascular Risk
- Adjunctive therapy to low dose Aspirin or Clopidogrel (Plavix)
IV. Contraindications
- Prior Cerebrovascular Accident (CVA) or Transient Ischemic Attack (TIA)
- Vorapaxar is associated with an increase risk of Hemorrhagic CVA in patients with prior cerebrovascular events
- Combination with other antiplatelet agents (other than Aspirin or Clopidogrel)
- Has not been studied with Prasugrel (Effient) or Ticagrelor (Brilinta)
- Avoid with strong CYP3A4 inhibitors or strong CYP3A4 inducers
V. Dosing
- Take 2.08 mg orally daily
VI. Drug Interactions
- Strong CYP3A4 inhibitors (e.g. Clarithromycin, Ritonavir, Ketoconazole)
- Strong CYP3A4 inducers (e.g. Carbamazepine, Phenytoin, Rifampin)
VII. Precautions
- Long Half-Life
- No antidote in the case of severe bleeding
VIII. Safety
- Pregnancy Category B
- Contraindicated in Lactation