Possible Interaction: Vitamin K and Rivaroxaban

“These two cases highlight for the inefficacy of rivaroxaban preventing severe thrombotic events such as catastrophic antiphospholipid syndrome and thus provide further support for recommendations that vitamin K antagonists must remain the reference anticoagulant in patients with triple-positive antiphospholipid antibodies.”

“High dose dabigatran (RR 0.83, 95% CI 0.72 to 0.96), ….75), apixaban (RR 0,67 , 95% Cl 0.51 to 0.88), high dose rivaroxaban (RR 0.66, 95% CI 0.52 to 0.83), … 0.88) probably reduce non-major bleeding more than vitamin K ….”

“Real-world evidence indicates superior rates of drug adherence with rivaroxaban when compared with vitamin K antagonists and with alternative non-vitamin K oral anticoagulants – perhaps, in part, due to its once-daily dosing regimen.”

“ConclusionsThere is a 22% risk that rivaroxaban offers a worse rather than a better benefit/risk profile than vitamin K antagonists in premenopausal women.”

“Furthermore, rivaroxaban discontinuation rates were considerably lower than those reported for vitamin K antagonists.”

“Furthermore, like all of the novel oral anticoagulants, rivaroxaban provides a significant reduction in intracerebral hemorrhage compared with vitamin K antagonists such as warfarin.”