Zontivity (vorapaxar) keeps the platelets in your blood from coagulating (clotting) to prevent unwanted blood clots that can occur with certain heart or blood vessel conditions.
Zontivity is used to lower the risk of stroke or serious heart problems in people who have had a heart attack or a blood vessel disorder affecting circulation in the arms and legs.
Zontivity is sometimes used together with aspirin or clopidogrel (Plavix).
Important information
You should not use Zontivity if you have active bleeding, stomach or intestinal bleeding, a head injury, or if you have a history of stroke (including "mini-stroke"), bleeding in your brain, or increased pressure inside the skull.
Zontivity increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have a light-headed feeling, sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, or problems with vision or balance.
Before taking this medicine
You should not use Zontivity if you are allergic to vorapaxar, or if you have:
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active bleeding;
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stomach or intestinal bleeding;
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a head injury or bleeding in your head;
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a history of stroke;
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a history of transient ischemic attack (TIA) or "mini-stroke"; or
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a history of bleeding in your brain or increased pressure inside the skull.
Zontivity increases your risk of bleeding, which can be severe or life-threatening, especially if:
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you have a bleeding or blood clotting disorder such as hemophilia;
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you are an older adult;
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you are underweight;
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you have liver or kidney disease;
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you take a blood thinner (warfarin, Coumadin, Jantoven);
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you take certain antidepressants (Celexa, Paxil, Prozac, Zoloft, Cymbalta, Effexor, and others); or
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you take an NSAID (nonsteroidal anti-inflammatory drug) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.
To make sure Zontivity is safe for you, tell your doctor if you have recently had any heart procedures, such as:
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heart bypass surgery (coronary artery bypass graft, or CABG);
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angioplasty (a catheter is inserted to place a "stent" in a blood vessel to open up a blocked or narrowed artery); or
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coronary angiography (a special dye is injected into a blood vessel that allows your coronary arteries to be easily seen on an x-ray).
FDA pregnancy category B. Zontivity is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
See also: Pregnancy and breastfeeding warnings (in more detail)
It is not known whether vorapaxar passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
How should I take Zontivity?
Zontivity is usually taken once per day. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
You may take Zontivity with or without food.
You may also need to take aspirin or clopidogrel (Plavix). Follow your doctor"s instructions very carefully.
If you need surgery or any dental work, tell the surgeon or dentist ahead of time that you are using Zontivity. You may need to stop using the medicine for a short time to prevent bleeding.
Do not stop using Zontivity without your doctor"s advice. Stopping suddenly may make your condition worse.
Zontivity can have long lasting effects in your body. You may still bleed more easily for as long as 4 weeks after you stop using this medicine.
Store at room temperature away from moisture and heat. Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Zontivity?
Follow your doctor"s instructions about any restrictions on food, beverages, or activity.
Zontivity side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Zontivity: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
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a light-headed feeling, like you might pass out;
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easy bruising or bleeding (nosebleeds, bleeding gums);
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red or pink urine, bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
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any bleeding that will not stop;
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pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating; or
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signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.
Common Zontivity side effects may include:
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bleeding;
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depression; or
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rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Zontivity?
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Zontivity, especially:
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nefazodone;
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St. John"s wort;
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an antibiotic - clarithromycin, rifampin, telithromycin;
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antifungal medication - itraconazole, ketoconazole, posaconazole, voriconazole;
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cancer medicine - enzalutamide, mitotane;
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hepatitis C medications - boceprevir, telaprevir;
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HIV/AIDS medication - atazanavir, cobicistat (Stribild, Tybost), delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir; or
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seizure medication - carbamazepine, fosphenytoin, phenobarbital, phenytoin, primidone.
Other drugs may interact with vorapaxar, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
