{"id":"vorapaxar","rwe":[{"pmid":"41686764","year":"2026","title":"Analysis and mining of adverse events associated with vorapaxar: A FAERS database-based study.","finding":"","journal":"PloS one","studyType":"Clinical Study"},{"pmid":"41571191","year":"2026","title":"Differential regulation of cyclic adenosine monophosphate by phosphodiesterase 3A discriminates thrombin-induced protease activated receptor 1- and 4-dependent platelet activation.","finding":"","journal":"Journal of thrombosis and haemostasis : JTH","studyType":"Clinical Study"},{"pmid":"41557909","year":"2026","title":"Understanding how a highly prevalent GRK5 polymorphism affects platelets and enhances thrombotic risk.","finding":"","journal":"Blood","studyType":"Clinical Study"},{"pmid":"41448540","year":"2026","title":"PlateChek: a surface-functionalized dielectric microsensor for specific detection of platelet-related hemostatic impairment in whole blood.","finding":"","journal":"Journal of thrombosis and haemostasis : JTH","studyType":"Clinical Study"},{"pmid":"41278464","year":"2025","title":"Identification of novel gene expression programs in thrombin-stimulated hepatic stellate cells.","finding":"","journal":"Research and practice in thrombosis and haemostasis","studyType":"Clinical Study"}],"tags":[{"label":"Protease-activated Receptor-1 Antagonist","category":"class"},{"label":"Small Molecule","category":"modality"},{"label":"Proteinase-activated receptor 1","category":"target"},{"label":"F2R","category":"gene"},{"label":"B01AC26","category":"atc"},{"label":"Oral","category":"route"},{"label":"Tablet","category":"form"},{"label":"LOE Approaching","category":"status"},{"label":"Cerebrovascular accident","category":"indication"},{"label":"Myocardial Infarction Prevention","category":"indication"},{"label":"Key Therap","category":"company"},{"label":"Approved 2010s","category":"decade"},{"label":"Hematologic Agents","category":"pharmacology"},{"label":"Platelet Aggregation Inhibitors","category":"pharmacology"}],"phase":"marketed","safety":{"commonSideEffects":[],"contraindications":["Cerebral hemorrhage","Transient ischemic attack"],"specialPopulations":{"Lactation":"There are no data on the presence of vorapaxar or its metabolites in human milk, the effects on the breastfed infant, or the effects on milk production. When vorapaxar was administered to lactating rats, vorapaxar was actively secreted in the milk of rats. When drug is present in animal milk, it is likely the drug will be present in human milk. Because of the potential for serious adverse reactions in the breastfed infant, such as bleeding, advise patients that breastfeeding is not recommended.","Pregnancy":"When pregnancy is detected, discontinue vorapaxar and initiate appropriate alternative therapy. Risk SummaryBased on the potential for serious adverse reactions (such as maternal bleeding/hemorrhage) and the long half-life which makes it effectively irreversible, discontinue vorapaxar when pregnancy is detected and initiate alternative therapy with shorter duration of action. Available data from postmarketing experience with ZONTIVITY use in pregnant women are insufficient to evaluate for drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.","Geriatric use":"In TRA 2P, in post-MI or PAD patients without history of stroke or TIA, 33% of patients were >=65 years of age and 9% were >=75 years of age. The relative risk of bleeding (ZONTIVITY compared with placebo) was similar across age groups. No overall differences in safety or effectiveness were observed between these patients and younger patients. ZONTIVITY increases the risk of bleeding in proportion to patients underlying risk. Because older patients are generally at higher risk of bleeding, use caution when initiating ZONTIVITY in geriatric patients.","Paediatric use":"The safety and effectiveness of ZONTIVITY in pediatric patients have not been established."}},"trials":[],"aliases":[],"company":"Key Therap","patents":[{"applNo":"N204886","source":"FDA Orange Book","status":"Active","expires":"Dec 23, 2027","useCode":"U-1512","territory":"US","drugProduct":true,"patentNumber":"7304078","drugSubstance":true}],"pricing":[],"_sources":{"trials":{"url":"https://clinicaltrials.gov/search?intr=VORAPAXAR","method":"api_direct","source":"ClinicalTrials.gov","rawText":"","confidence":1,"sourceType":"ctgov","retrievedAt":"2026-04-20T00:48:59.583701+00:00"},"patents":{"url":"","method":"deterministic","source":"FDA Orange Book","rawText":"","confidence":1,"sourceType":"fda_orange_book","retrievedAt":"2026-04-20T00:48:59.583552+00:00"},"regulatory.ca":{"url":"","method":"api_direct","source":"Health Canada DPD","rawText":"","confidence":1,"sourceType":"health_canada_dpd","retrievedAt":"2026-04-20T00:49:07.355921+00:00"},"regulatory.eu":{"url":"","method":"api_direct","source":"European Medicines Agency","rawText":"","confidence":1,"sourceType":"ema_api","retrievedAt":"2026-04-20T00:48:59.613251+00:00"},"publicationCount":{"url":"https://pubmed.ncbi.nlm.nih.gov/?term=VORAPAXAR","method":"api_direct","source":"PubMed/NCBI","rawText":"","confidence":1,"sourceType":"pubmed","retrievedAt":"2026-04-20T00:49:08.127076+00:00"},"crossReferences.chemblId":{"url":"https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL493982/","method":"api_direct","source":"ChEMBL (EMBL-EBI)","rawText":"","confidence":1,"sourceType":"chembl","retrievedAt":"2026-04-20T00:49:08.620653+00:00"}},"allNames":"zontivity","offLabel":[],"synonyms":["SCH-530348","SCH530348","vorapaxar","vorapaxar sulfate","zontivity","SCH 530348"],"timeline":[{"date":"2014-01-01","type":"neutral","source":"FDA Orange Book","milestone":"Rights transferred from MERCK SHARP DOHME to Key Therap"},{"date":"2014-05-08","type":"positive","source":"DrugCentral","milestone":"FDA approval (Merck Sharp Dohme)"},{"date":"2014-11-20","type":"positive","source":"DrugCentral","milestone":"EMA approval (Merck Sharp & Dohme Limited)"},{"date":"2027-12-23","type":"negative","source":"FDA Orange Book","milestone":"Substance patent 7304078 expires"}],"aiSummary":"Zontivity (VORAPAXAR) is a small molecule protease-activated receptor-1 antagonist developed by Merck Sharp Dohme and currently owned by Key Therap. It targets the proteinase-activated receptor 1 to prevent blood clots and is approved for the prevention of myocardial infarction and cerebrovascular accidents. Zontivity was FDA-approved in 2014 and has a long half-life of 149 hours. The commercial status of Zontivity is patented, with no generic manufacturers available. Key safety considerations include its potential to increase the risk of bleeding.","approvals":[{"date":"2014-05-08","orphan":false,"company":"MERCK SHARP DOHME","regulator":"FDA"},{"date":"2014-11-20","orphan":false,"company":"Merck Sharp & Dohme Limited","regulator":"EMA"}],"brandName":"Zontivity","ecosystem":[{"indication":"Cerebrovascular accident","otherDrugs":[{"name":"amlodipine","slug":"amlodipine","company":"Pfizer"},{"name":"atorvastatin","slug":"atorvastatin","company":"Pfizer"},{"name":"pravastatin","slug":"pravastatin","company":"Bristol Myers Squibb"},{"name":"ramipril","slug":"ramipril","company":"King Pharms"}],"globalPrevalence":101000000},{"indication":"Myocardial Infarction Prevention","otherDrugs":[{"name":"amlodipine","slug":"amlodipine","company":"Pfizer"},{"name":"atorvastatin","slug":"atorvastatin","company":"Pfizer"},{"name":"lovastatin","slug":"lovastatin","company":"Merck"},{"name":"perindopril","slug":"perindopril","company":"Symplmed Pharms Llc"}],"globalPrevalence":523000000}],"mechanism":{"target":"Proteinase-activated receptor 1","novelty":"Follow-on","targets":[{"gene":"F2R","source":"DrugCentral","target":"Proteinase-activated receptor 1","protein":"Proteinase-activated receptor 1"}],"moaClass":"Protease-activated Receptor-1 Antagonists","modality":"Small Molecule","drugClass":"Protease-activated Receptor-1 Antagonist","explanation":"","oneSentence":"","technicalDetail":"Zontivity (VORAPAXAR) selectively and reversibly binds to the protease-activated receptor 1 (PAR-1) on platelet surfaces, inhibiting thrombin-induced platelet activation and aggregation."},"commercial":{"launchDate":"2014","_launchSource":"DrugCentral (FDA 2014-05-08, MERCK SHARP DOHME)"},"references":[{"id":1,"url":"https://drugcentral.org/drugcard/4870","fields":["approvals","synonyms","ATC","PK","indications","contraindications","DDIs","targets","patents","FAERS"],"source":"DrugCentral"},{"id":2,"url":"https://clinicaltrials.gov/search?intr=VORAPAXAR","fields":["trials"],"source":"ClinicalTrials.gov"},{"id":3,"url":"https://pubmed.ncbi.nlm.nih.gov/?term=VORAPAXAR","fields":["publications"],"source":"PubMed/NCBI"},{"id":4,"url":"https://www.fda.gov/drugs/drug-approvals-and-databases/orange-book-data-files","fields":["patents","exclusivity","genericManufacturers"],"source":"FDA Orange Book"}],"_emaChecked":true,"_enrichedAt":"2026-03-30T16:14:42.673051","_validation":{"fieldsValidated":0,"lastValidatedAt":"2026-04-20T00:49:10.537271+00:00","fieldsConflicting":2,"overallConfidence":0.8},"biosimilars":[],"competitors":[{"drugName":"clopidogrel","drugSlug":"clopidogrel","fdaApproval":"1997-11-17","genericCount":23,"patentStatus":"Off-patent — generic 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