What is it about?
Apixaban and rivaroxaban are metabolized via the CYP 3A4 system. Induction of these enzymes may lead to reduced efficacy. Carbamazepine is a potent inducer of this enzyme. We describe a case series where carbamazepine and apixaban or rivaroxaban were given concomitantly. In some cases this was potentially associated with loss of efficacy. In our opinion there is a lack of awareness of this interaction
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Why is it important?
People may not know about the clinical importance of an interaction between a DOAC and carbamazepine. Loss of anticoagulation efficacy may result in thromboembolic events i.e. pulmonary embolus
Perspectives
Writing this article emphasises the importance of anticoagulation stewardship involvement
Carmela corallo
Alfred Health
Read the Original
This page is a summary of: Increasing Understanding Regarding the Risk of Concomitant Use of Carbamazepine and Direct Oral Anticoagulants, Journal of Pharmacy Practice, July 2018, SAGE Publications,
DOI: 10.1177/0897190018786837.
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