Vorapaxar also known as Zontivity, is an inhibitor for platelet aggregation used to treat patients with a history of myocardial infarction or peripheral arterial disease to reduce the chance of thrombotic cardiovascular events. Vorapaxar inhibits protease-activated receptor 1 (PAR-1), which is a G protein-coupled receptor that is expressed on the platelet. Inhibition of PAR-1 prevents platelet aggregation and activation. Vorapaxar is administered orally and rapidly absorbs and travels through the bloodstream. It is metabolized to major metabolites M20 and M19 by CYP3A4 and CYP2J2. This is then eliminated primarily through feces and urine. Due to the anticoagulant and antiplatelet nature, herbs and supplements with similar activity should be avoided such as garlic, ginger, bilberry, danshen, piracetam and ginkgo biloba. St.John's Wort should also be avoided as it induces CYP3A metabolism and will reduce the concentration of Vorapaxar. Caution should be exercised with grapefruit products, as coadministration with strong inhibitors should be avoided.

Vorapaxar Pathway References