Adult Dosing

Reduction of thrombotic cardiovascular events

• 2.08 mg PO Daily
• Use in combination with aspirin and/or clopidogrel according to their indications or standard of care
• There is limited experience other anti-platelet drugs or with use of vorapaxar alone

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• To reduce thrombotic cardiovascular events in patients who have history of myocardial infarction or with peripheral arterial disease

• Hypersensitivity to any of the ingredients of the drug
• History of stroke, Transient Ischemic Attack, or Intracranial Hemorrhage
• Active pathologic bleeding

• Do not use vorapaxar in patients with a history of stroke, transient ischemic attack (TIA), or intracranial hemorrhage (ICH)
• Do not use in patients with active pathological bleeding
• Vorapaxar increases risk of bleeding, including ICH and fatal bleeding

Renal Dose Adjustment

• Renal impairment: No dose adjustment

Hepatic Dose Adjustment

• Mild and moderate hepatic impairment: No dose adjustment
• Severe hepatic impairment: Not recommended

• Vorapaxar increases risk of bleeding, including ICH and fatal bleeding [US Black Box Warning]
• Avoid coadministration of vorapaxar with strong CYP3A inhibitors or inducers, because strong CYP3A inhibitors increase and inducers decrease vorapaxar exposure

Caution: Use cautiously in

• Risk of bleeding

Pregnancy Category:B

Breastfeeding: Safety unknown; excreted in the milk of rats; because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants manufacturer recommends discontinuation of breastfeeding, or discontinue treatment.

• HEMA: Bleeding, fatal bleeding, anemia
• NEURO: Intracranial hemorrhage
• GI: GI bleeding
• PSYCHIATRY: Depression
• DERM: Rashes, eruptions, exanthemas

• Reversible antagonist of the protease-activated receptor-1 (PAR-1); expressed on platelets, but its long half-life makes it effectively irreversible
• Metabolized by CYP3A4 and CYP2J2
• Excretion: 58% feces; 25% urine
• Half-life: 3-4 days (disposition); 8 days (terminal elimination)

US Trade Name(s)

• Zontivity

US Availability

Zontivity

• TABS: 2.08 mg

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Hematology/Oncology

Antiplatelet Agents

Platelet Aggregation Inhibitors

Cardiovascular

Antiplatelet Agents

Platelet Aggregation Inhibitors