Can I take Mirabegron and Rivaroxaban together?

Why this happens

Mirabegron and rivaroxaban are processed by different pathways in the body. Mirabegron is primarily broken down by enzymes called CYP3A4 and CYP2D6, while rivaroxaban is processed by CYP3A4 and a transport protein called P-gp.

While they share the CYP3A4 pathway, studies show that mirabegron does not significantly change the levels of drugs like rivaroxaban in the blood.

You can take both medications as prescribed by your doctor. However, always monitor for any unusual side effects, such as unexpected bruising or bleeding (related to rivaroxaban) or a very fast heartbeat (related to mirabegron).

If you notice anything unusual, contact your GP or pharmacist.

Bleeding risk

This medicine significantly increases your risk of serious bleeding. Seek immediate medical help if you have a fall or head injury, or if you notice signs of internal bleeding such as black tarry stools, coughing up blood, or persistent nosebleeds.

Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen while on rivaroxaban, as this significantly increases your risk of stomach bleeding.

Surgery and dental procedures

You must tell your surgeon or dentist that you are taking rivaroxaban before any procedure, as you may need to stop taking it temporarily to prevent excessive bleeding.

Severe uncontrolled high blood pressure

Do not take mirabegron if your blood pressure is very high (180/110 mmHg or higher). It can significantly increase blood pressure and should be monitored regularly during treatment.

Alcohol

It is best to avoid or strictly limit alcohol while taking mirabegron. Alcohol can irritate the bladder and increase urine production, which may counteract the benefits of your treatment. Additionally, both alcohol and mirabegron can affect your blood pressure; combining them may increase the risk of dizziness or lightheadedness.

It is best to avoid or strictly limit alcohol while taking rivaroxaban. Alcohol can increase the risk of bleeding in the stomach and intestines, and it may also affect how quickly your blood clots, which can be dangerous when combined with a blood thinner.

Caffeine (Coffee, tea, energy drinks, cola)

Mirabegron is used to treat an overactive bladder. Caffeine is a natural diuretic and bladder irritant that can worsen the symptoms you are taking this medicine to treat (such as urgency and frequency). You should limit your intake of caffeinated drinks to help the medicine work effectively.

Food (General)

If you have been prescribed the 15mg or 20mg strength of rivaroxaban, you must take it with food. This helps your body absorb the medicine properly so it can work effectively. The lower 2.5mg and 10mg doses can be taken with or without food.

Grapefruit juice

While the interaction is less severe than with some other medicines, large amounts of grapefruit juice may increase the levels of rivaroxaban in your blood, potentially increasing your risk of bleeding. It is safest to avoid large quantities.

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.