Can I take Rivaroxaban and Aspirin together?

Why this happens

Both medicines work to prevent blood clots but in different ways. Rivaroxaban is an anticoagulant (blood thinner) that interferes with clotting proteins, while aspirin is an antiplatelet medicine that stops blood cells from sticking together. Using them together creates a 'double' thinning effect on the blood.

What you should do

Do not take aspirin with rivaroxaban unless your specialist doctor has specifically told you to do so (for example, if you have a heart stent). If you are prescribed both, watch closely for signs of bleeding, such as dark/tarry stools, coughing up blood, or severe bruising. Always tell your pharmacist you are on rivaroxaban before buying over-the-counter painkillers, as many contain aspirin or similar drugs like ibuprofen.

Important precautions

Bleeding risk and surgery

Taking these medicines together significantly increases your risk of serious, potentially life-threatening bleeding. You must watch for signs such as coughing up blood, vomit that looks like coffee grounds, black tarry stools, or unexplained bruising. Seek immediate medical help if you have a serious fall or head injury.

You must tell any doctor, dentist, or surgeon that you are taking these medicines before any procedure, as they significantly increase your risk of bleeding and may need to be stopped temporarily.

NSAID use (e.g. ibuprofen, naproxen)

Do not take anti-inflammatory painkillers like ibuprofen or naproxen while on these medicines unless specifically prescribed, as this combination severely increases the risk of dangerous internal bleeding.

Asthma

If you have asthma, aspirin can trigger a severe worsening of your symptoms or a life-threatening allergic reaction; do not take it if you have ever had a reaction to similar painkillers.

Children and teenagers under 16

Never give aspirin to children or teenagers under 16 unless specifically prescribed by a doctor. It can cause Reye’s syndrome, a rare but very serious condition that causes swelling in the liver and brain.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Both aspirin and rivaroxaban thin your blood; alcohol can further increase the risk of serious bleeding, particularly in the stomach and digestive tract. Alcohol also increases the risk of liver damage when combined with regular medication use.

Food (General)

You must take the 15mg and 20mg doses of rivaroxaban with food. This helps your body absorb the medicine properly so it can work effectively. The 2.5mg and 10mg doses can be taken with or without food.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.