Carbamazepine interaction with direct oral anticoagulants: help from the laboratory for the personalized management of oral anticoagulant therapy

Risultato della ricerca: Contributo in rivistaArticolo in rivista

10 Citazioni (Scopus)

Abstract

Current guidelines recommend caution in prescribing concomitant use of direct-acting oral anticoagulants (DOACs) and antiepileptic drugs due to drug–drug interactions leading to potential risk of DOACs subtherapeutic concentration and treatment failure. Herein we report a significant interaction between carbamazepine (CZP) and apixaban, causing subtherapeutic concentration of the drug in a patient with atrial fibrillation who had a transient ischemic attack (TIA) episode. Another anti-Xa DOAC, edoxaban, administered to the patient after TIA occurrence did not show significant interaction with CZP. In addition to confirm that cautions should be used when antiepileptic and DOACs are concomitantly prescribed, the present case also demonstrates that, in the management of certain subsets of patients who need anticoagulant treatment, measurement of DOAC plasma concentration can help guide a personalized management and avoid adverse clinical outcomes.
Lingua originaleEnglish
pagine (da-a)528-531
Numero di pagine4
RivistaJOURNAL OF THROMBOSIS AND THROMBOLYSIS
Volume48
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Anti-Xa activity
  • Anticonvulsants
  • Atrial Fibrillation
  • Carbamazepin
  • Carbamazepine
  • DOAC interaction
  • Direct oral anticoagulant
  • Drug Interactions
  • Drug Monitoring
  • Factor Xa Inhibitors
  • Humans
  • Ischemic Attack, Transient
  • Personalized oral anticoagulant therapy
  • Precision Medicine
  • Pyrazoles
  • Pyridines
  • Pyridones
  • Thiazoles

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