Xarelto (Rivaroxaban) and recreational drugs

[SpaceSquirrel]

Hi there,

I was wondering if anyone here knows if there are interactions between the blood thinner Xarelto (rivaroxaban) and recreational drugs such as MDMA, amphetamine, LSD, Magic Mushrooms, weed, nitrous, 2CB or GHB.

According to drugs.com there are no known interactions between amphetamine/adderall, GHB/xyrem or nitrous and xarelto, but I don't know if their database is exhaustive.
Alcohol seems to be fine in moderation which makes me guess that GHB should be fine in moderation, too.
I have no idea about the rest.

We can presume that precautions are being taken to reduce the increased risk of accidents while high (you don't want any internal or external bleeding while on blood thinners obviously) and we're talking about occasional, moderate weekend use, no binges.

Thank you!

 

[《Plasticity》]

Information on the interactions between anticoagulants and recreational drugs is extremely hard to find, especially regarding the newer generation of blood thinners. Sadly I don't even think you will find the information your looking for here, though maybe some of the people in the NPD sub-forum can offer some help. I can't help you out either, but since I recently suffered medical complications that would include a regimen of blood thinners (which I respectfully declined due to bleeding risks) I spent alot of time looking into this, being that I'm a drug user.

It appears that Rivaroxiban interacts with far fewer drugs than Warfarin, but something to keep in mind is that unlike Warfarin, IF you happen to take a substance that does trigger internal bleeding, it will not be able to be reversed. This is probably a pointless post pointing out things you already know (sorry if it is), but I just want to reinforce how potentially dangerous things can go if you decide to dabble in drugs. Your best bet would be to avoid drugs until you find concrete information on these interactions, because the risk is huge with this one. Please proceed with caution until you find the information your looking for, sorry that I can't help you with the answers your actually seeking

 

[Kittycat5]

As CK said, there really isnt a whole lot of data on interactions of recreational and pharmaceutical drugs. However, MDMA and LSD may not be a good idea if you are using Xarelto for DVT. Serotonin release ( MDMA) and 5ht2a agonism (LSD) both play a role in platelet aggregation and platelet aggregation plays a role in thrombus formation. While Xarelto is not an inhibitor of this aggregation like clopidogrel and neither MDMA nor LSD will stop it from doing what it does, they very well may worsen a DVT nonetheless. I would just avoid any recreational drugs while on the Xarelto to be safe.

 

[SpaceSquirrel]

Oh wow, thanks for your thoughtful replies despite the lack of dependable data. Especially the link between serotonin and platelet aggregation was helpful. So even if there are no interactions between the substances MDMA and LSD are a risk factor for DVT. Very good to know.
I'll have to put most things on hold anyway until my cardiovascular system has sufficiently recovered from the lung embolism that almost killed me - but I'll have to take Xarelto for much longer than that. I'm definitely going to to weigh up risks and benefits carefully and talk to a doctor or two as well (thankfully I know a few who have more to say than "just say no").

If anyone else has any additional info on the topic I'd love to hear it.

 

[《Plasticity》]

the lung embolism that nearly killed me

I hear you, I too recently suffered from a near fatal pulmonary embolism just 3 months ago. The clot even cut off blood flow to my heart for a little while temporarily weakening it. If your embolism was nearly as bad as mine, trust me, your gonna want to avoid stimulants like MDMA for a good while anyways as these will cause some nasty breathlessness spells and in my case, palpitations as well. Take this time as a break from drugs and be thankful that your still here, I believe the statistic is something like 30% of embolism sufferers die before they even get to the hospital, so your lucky to be breathing! I don't know how recovery has been for you, but I'm still quite far from 100%. Good luck, hope you make a quick recovery

 

[Erikmen]

I´m sorry to hear that..

 

[《Plasticity》]

If your talkin to me, It's all good . Just happy to be here!

 

[SpaceSquirrel]

I hear you, I too recently suffered from a near fatal pulmonary embolism just 3 months ago. The clot even cut off blood flow to my heart for a little while temporarily weakening it. If your embolism was nearly as bad as mine, trust me, your gonna want to avoid stimulants like MDMA for a good while anyways as these will cause some nasty breathlessness spells and in my case, palpitations as well.

Oh goodness. How come? Yes, mine was probably similar, main arteries in both lungs blocked, heart working like crazy, I just collapsed in the street. I was in intensive care for two days and in hospital for a week and I'm quite grateful I survived.

Take this time as a break from drugs and be thankful that your still here, I believe the statistic is something like 30% of embolism sufferers die before they even get to the hospital, so your lucky to be breathing! I don't know how recovery has been for you, but I'm still quite far from 100%. Good luck, hope you make a quick recovery

Thanks so much. I've only been home for a couple of days, so it's all very fresh. I actually feel fine for the most part, other than that I get short of breath and work up a sweat pretty easily. I guess that I already think of partying again is a good sign, as long as I don't act on it. I figured no stims until I'm back to my previous level of fitness (work, sports etc). I was hoping that'd be less than three months though. Sighs. I was also hoping to be able to do some GHB and/or 2CB for new year's eve since MDMA is out of the question apparantly, but I'll check with my doctor beforehand.

Are you taking anything currently?

 

[《Plasticity》]

No meds, like I said I declined anticoagulants for many reasons. The main being that I have GERD and a history of stomach ulcers and the bleeding risk didn't seem worth the potential benefit, but also because I just don't trust the drugs with all the interactions and restrictions, and it's really the first 3 months that your at the highest risk of recurring clots and it took me over 2 months just to get a proper diagnosis due to terrible hospital care.

Because I have a diagnosis for anxiety I was constantly sent home from the ER with the label "anxiety", same with my GP. It was an incredibly frustrating process being told all your issues are in your head when your litterally struggling to breath every single day . If by "taking anything" you were reffering to recreational substances, I do take opioids regularly, though most other classes of drugs exacerbate my symptoms and I fear I may further damage my lungs should I choose to delve right back into my old habits. Just taking it easy on my level of drug use for now...

Don't let my slow progress worry you though, it sounds like my embolism was a bit more damaging and it's important to keep in mind that most people recover in a few weeks to months. For the first 2 months or so I would palpitate like hell everytime I ate, my BP would regularly soar into the 150's, had constant breathlessness, chest pains, pressure in my chest... a whole lot more than what your going through so I'd imagine your recovery is gonna be alot smoother, though only time will tell.

 

[SpaceSquirrel]

Thank you for sharing ... ok, that sounds worse than my case indeed. I wish you the fastest recovery possible!

I've since had two pretty extensive GHB/nitrous sessions with no adverse effects. From all I could gather there are no liver enzyme related interactions and neither caues pulmonary hypertension (according to a doc I'm happy to be able to ask about such things). For all intents and purposes I'm feeling fine again except for the pain caused by the thrombosis in my leg but I'll still wait a couple of weeks with any stims (as well as exhausting sports). And I'm still not sure if there's a CYP3A4 interaction between Xarelto and MDMA (I asked that specific question here).

 

[Danjeli]

Hi there I have also suffered from a pe last month and am on warfarin. Am now weighing the possibility of switching to xarelto mainly due to having a few drinks and partyin eating weed etc. How did you find xarelto till now?

 

[SpaceSquirrel]

Hi there I have also suffered from a pe last month and am on warfarin. Am now weighing the possibility of switching to xarelto mainly due to having a few drinks and partyin eating weed etc. How did you find xarelto till now?

Hi there I have also suffered from a pe last month and am on warfarin. Am now weighing the possibility of switching to xarelto mainly due to having a few drinks and partyin eating weed etc. How did you find xarelto till now?

I'm pretty happy with it actually. The standard starter dose of 2 X 15mg caused an unstoppable super heavy period for me, so my doc put me on 1 X 20mg a few days earlier than the recommended three weeks. No problems at all since then. Seems to mix well with weed, amphetamine, GHB and nitrous (low to medium dosed weekend/party use, mostly one at a time). Finally found a doc who sifted through the available studies regarding MDMA and CYP3A4 - conclusion is that there might be an interaction or not, the data is inconclusive. Recommendation was to wait a few hours between taking either to be safe. I'll try that and report back. Decided to take a break from the major psychedelics due to possible interactions and danger of injury due to loss of coordination. It'll only be a few months more. I don't like alcohol much but Doc said it would be fine unless I drink enough to hit my head etc.

So all in all there's way less interaction and hassle than I've heard about being the case with warfarin. I'd recommend it.

All the best for your recovery!

 

[Danjeli]

Thank you for your reply. My recovery is going well hope yours is too.
Am not thinking of taking mdma for a while as i think it might have been a factor in me getting the pe in the firstplace. But would be great if it doesn't affect/mix badly as it was my drug of choice till xmas. so someday I might give in and I'm just 28 with possibility of lifelong treatment. thats a long time... (hopefully)
Am switching to rivaroxiban this week.
will report back.

Get well soon and all the best

 

[SpaceSquirrel]

Went on a MDMA mini binge last weekend, 5 x 70 mg within two nights. I made sure to leave 4 - 5 hours each between xarelto - MDMA and vice versa. No problems (other than the inevitable nasty comedown, yuck). When I accidentally cut myself while shaving on Monday morning there was no excessive bleeding. That's only one case now of course, but we can say that mdma while on xarelto doesn't necessarily cause issues.

 

[Danjeli]

Same here did some at a 3 day rave. No adverse effect on it whatsoever. Just a bit of paranoia on comedown on the first day. I take xarelto in the morning to make sure it wears off by the time im out. This is definitely much better than being on warfarin.

 

[LilikoiMoon]

No, it isn't completely safe. Anything that alters a sober, clear mind can cause you to fall, or harm yourself, resulting in hemmorhage if you injure yourself.

Just look at it from that angle.


Xeralto is so much better than that poison, Coumadin, but there are still risk with all BT's.

Also, any medications that can irritate the lining of your stomach (opiates/acet , asprin, herbs, alcohol, etc.) should be avoided due to internal bleeding.

Enjoy what you can, just be cautious.


(Had a PE in my right lung a year ago, so understands the blood thinner rollercoaster)

 

[SpaceSquirrel]

Finally done with it ...

Alright, since I was finally able to quit Xarelto a few weeks ago here's a final summary of my experiences using recreational drugs with it.

• MDMA a few times, around 70mg per dose, up to three doses per night (once) and two nights in a row (twice). No noticable adverse effects.
• GHB often and not too little either. No noticable adverse effects.
• Quite a few lines of amphetamine (street grade speed) on several occasions, no problems.
• Mephedrone, a few lines once, no problems.
• Valium and Xanax a few times to sleep after parties.
• 2CB two or three times, around 15mg each, no problems.
• Weed (low dose, vaped) a few times with no problems.
• Alcohol and nicotine little and rarely without problems.
• Low doses of cocaine on several occasions, no problems - but be careful: "Chronic cocaine administration has been shown to induce CYP3A4 in rodents [7]. If cocaine induces CYP3A4 in humans as well, it may decrease levels and effectiveness of the many ARVs that are CYP3A4 substrates, including most NNRTIs and PIs." (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892618/). I wouldn't call my use chronic, I used less than a gram in several months.
• Piracetam (4,8g on three occasions to enhance MDMA) - now that was stupid because I learned later that Piracteam acts as a blood thinner itself and isn't supposed to be taken even with Aspirin. I had no problems but probably could have. D'uh.
• Nitrous balloons several times, up to ~10 chargers per session, no problems.

With everything I made sure to take Xarelto around lunchtime and the fun stuff around midnight give and take a few hours. Also to get sleep and eat in between even during multiple day festivals.

So yay. Survived that lung embolism, the rat poison and a bunch of illegalized substances. I guess I'm meant to stay for a little bit longer still.