Does Phenytoin Interact With Rivaroxaban?
7.3 Drugs that Induce Cytochrome P450 3A Enzymes and Drug Transport Systems Avoid concomitant use of XARELTO with drugs that are combined P-gp and strong CYP3A inducers (e.g., carbamazepine, phenytoin, rifampin, St.
Severity: Major
Severity basis: drug interactions section (keywords: avoid). Combining Phenytoin (Anticonvulsant) and Rivaroxaban (Factor Xa inhibitor anticoagulant) is classified as a major interaction.
What to Do
The label advises avoiding this combination or using it only under close medical supervision. Talk to your prescriber or pharmacist before combining them.
How This Interaction Works
Interactions like this one can happen when two medicines have overlapping effects, or when one changes how the other is absorbed, broken down, or cleared from the body. Phenytoin is a anticonvulsant and Rivaroxaban is a factor xa inhibitor anticoagulant; together they are documented as a major interaction. How much this matters depends on your dose, your other medications, and your overall health.
If You Take Both Medications
If you have been prescribed both Phenytoin and Rivaroxaban, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
From the FDA Label
7.3 Drugs that Induce Cytochrome P450 3A Enzymes and Drug Transport Systems Avoid concomitant use of XARELTO with drugs that are combined P-gp and strong CYP3A inducers (e.g., carbamazepine, phenytoin, rifampin, St.
Source: FDA structured product labeling (set_id 10db92f9-2300-4a80-836b-673e1ae91610).
Check these against your full medication list in our free Interaction Checker
Frequently Asked Questions
Can you take Phenytoin and Rivaroxaban together?
Phenytoin and Rivaroxaban have a documented major interaction. The label advises avoiding this combination or using it only under close medical supervision. Talk to your prescriber or pharmacist before combining them.
How serious is the Phenytoin and Rivaroxaban interaction?
It is classified as a major interaction, based on the FDA label's drug interactions section (keywords: avoid). A major interaction can cause serious harm and often calls for a change in therapy or close monitoring.
What should I do if I'm taking both Phenytoin and Rivaroxaban?
If you have been prescribed both Phenytoin and Rivaroxaban, do not start, stop, or change either medication on your own — some medicines are unsafe to stop suddenly. Tell your prescriber and pharmacist that you take both so they can decide whether the combination is right for you, adjust the dose, monitor you more closely, or suggest an alternative.
This information is educational — not medical advice.
This page is provided for general educational purposes and summarizes publicly available data from sources such as the U.S. Food & Drug Administration. It is not a substitute for the judgment of a licensed clinician and should not be used to start, stop, or change any medication. It may be incomplete or out of date, and individual circumstances vary. Always talk with your prescriber or pharmacist about your specific medications and health conditions. If you think you may have a medical emergency, call 911.
Other Phenytoin Interactions
- Phenytoin + Apixaban(major)
- Phenytoin + Itraconazole(major)
- Phenytoin + Methotrexate(major)
- Phenytoin + Rifampin(major)
- Phenytoin + Ticagrelor(major)
- Phenytoin + Amiodarone(moderate)
- Phenytoin + Atorvastatin(moderate)
- Phenytoin + Carbamazepine(moderate)
- Phenytoin + Carbidopa Levodopa(moderate)
- Phenytoin + Cholecalciferol(moderate)
- Phenytoin + Clarithromycin(moderate)
- Phenytoin + Cyclosporine(moderate)
- Phenytoin + Diazepam(moderate)
- Phenytoin + Digoxin(moderate)
- Phenytoin + Doxycycline(moderate)
- Phenytoin + Fluconazole(moderate)
- Phenytoin + Fluoxetine(moderate)
- Phenytoin + Folic Acid(moderate)
- Phenytoin + Furosemide(moderate)
- Phenytoin + Glimepiride(moderate)
- Phenytoin + Hydrocodone Acetaminophen(moderate)
- Phenytoin + Ketoconazole(moderate)
- Phenytoin + Lamotrigine(moderate)
- Phenytoin + Lithium(moderate)
- Phenytoin + Methylphenidate(moderate)
- Phenytoin + Methylprednisolone(moderate)
- Phenytoin + Mirtazapine(moderate)
- Phenytoin + Nifedipine(moderate)
- Phenytoin + Omeprazole(moderate)
- Phenytoin + Oxycodone(moderate)
- Phenytoin + Paroxetine(moderate)
- Phenytoin + Quetiapine(moderate)
- Phenytoin + Sertraline(moderate)
- Phenytoin + Simvastatin(moderate)
- Phenytoin + Tacrolimus(moderate)
- Phenytoin + Topiramate(moderate)
- Phenytoin + Tramadol(moderate)
- Phenytoin + Trazodone(moderate)
- Phenytoin + Sulfamethoxazole Trimethoprim(moderate)
- Phenytoin + Verapamil(moderate)
- Phenytoin + Warfarin(moderate)
- Phenytoin + Alprazolam(minor)
- Phenytoin + Atomoxetine(minor)
- Phenytoin + Azithromycin(minor)
- Phenytoin + Buprenorphine Naloxone(minor)
- Phenytoin + Bupropion(minor)
- Phenytoin + Canagliflozin(minor)
- Phenytoin + Clonazepam(minor)
- Phenytoin + Codeine(minor)
- Phenytoin + Dexamethasone(minor)
- Phenytoin + Gabapentin(minor)
- Phenytoin + Glipizide(minor)
- Phenytoin + Levothyroxine(minor)
- Phenytoin + Liothyronine(minor)
- Phenytoin + Metformin(minor)
- Phenytoin + Metronidazole(minor)
- Phenytoin + Modafinil(minor)
- Phenytoin + Ondansetron(minor)
- Phenytoin + Pregabalin(minor)
- Phenytoin + Sucralfate(minor)
- Phenytoin + Tadalafil(minor)
- Phenytoin + Valproic Acid(minor)
Other Rivaroxaban Interactions
- Rivaroxaban + Carbamazepine(major)
- Rivaroxaban + Itraconazole(major)
- Rivaroxaban + Ketoconazole(major)
- Rivaroxaban + Rifampin(major)
- Rivaroxaban + Aspirin(moderate)
- Rivaroxaban + Clarithromycin(moderate)
- Rivaroxaban + Clopidogrel(moderate)
- Rivaroxaban + Enoxaparin(moderate)
- Rivaroxaban + Warfarin(moderate)
- Rivaroxaban + Trazodone(minor)