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Vorapaxar
Aka: Vorapaxar, Zontivity, Protease-Activated Receptor-1 Antagonist, PAR-1 Antagonist
- Mechanism
- Protease-Activated Receptor-1 Antagonist (PAR-1 Antagonist)
- Inhibits platelet aggregation for 4 weeks after dose
- Indications
- Not intended to be used alone
- Limited to patients with very high cardiovascular risk
- Adjunctive therapy to low dose Aspirin or Clopidogrel (Plavix)
- Myocardial Infarction
- Peripheral Arterial Disease
- 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
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Drug Interactions
- Strong CYP3A4 inhibitors
- Strong CYP3A4 inducers
- Precautions
- Long half-life
- No antidote in the case of severe bleeding
- References
- Morrow (2012) N Engl J Med 366(15):1404-13 [PubMed]