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Vorapaxar increases the risk of bleeding, which may include bleeding in the brain and other serious (possibly fatal) bleeding problems. Do not use vorapaxar if you have had a stroke, mini-stroke (transient ischemic attack - TIA), or bleeding in the brain in the past; or if you have any current bleeding problems. Discuss the benefits and risks of this medication with your doctor.

Easy bruising/bleeding, such as nosebleeds, may occur. If this effect lasts or gets worse, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Get medical help right away if you have any very serious side effects, including any of these signs of bleeding: bleeding that doesn't stop or bleeding too much, stomach/abdominal pain, lasting nausea/vomiting, coughing or vomiting up blood, vomit that looks like coffee grounds, bloody/black/tarry stools, bloody/pink/dark urine, sudden severe headache, confusion, dizziness, fainting, seizures, unusual weakness, weakness on one side of the body, trouble speaking, unusual drowsiness, loss of consciousness. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Some products that may interact with this drug include: tipranavir, antidepressants (such as amitriptyline, clomipramine, SSRIs including paroxetine/citalopram, SNRIs including duloxetine/desvenlafaxine/venlafaxine), other drugs that can cause bleeding/bruising (including anticoagulants such as dabigatran, warfarin). Other medications can affect the removal of vorapaxar from your body, which may affect how vorapaxar works. Examples include azole antifungals (such as itraconazole, ketoconazole), cobicistat, HIV protease inhibitors (such as nelfinavir), macrolide antibiotics (such as clarithromycin), rifamycins (such as rifampin), ritonavir, St. John's wort, drugs used to treat seizures (such as carbamazepine, phenytoin), among others. Check all prescription and nonprescription medicine labels carefully since many contain pain relievers/fever reducers (aspirin, NSAIDs such as ibuprofen or naproxen). These drugs also have anti-platelet effects and may increase your risk of side effects if taken together. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.