Skip to content
Research Article Open access CC BY 4.0

How to Manage an Anticoagulated Patient in Case of Drug-Drug Interaction?

A. García-Raso, P. Llamas Sillero

International Journal of Medical and Pharmaceutical Case Reports · pp. 27–33 · Published 27 Dec 2014

10.9734/IJMPCR/2015/14573

Abstract

Aims: The aim of this publication is to present the case of management of a patient on anticoagulation therapy with rivaroxoban in the context of a drug-drug interaction. Presentation of Case: We report the case of a 73-year-old male diagnosed as having non-valvular atrial fibrillation treated with oral anticoagulants: dabigatran, acenocumarol and rivaroxaban in sequence. Discussion: During concomitant administration of rivaroxaban and other commonly used agents, drug-drug interactions may occur. These can occur at the level of absorption, distribution, or clearance and are largely mediated by the P-gp transporter and the P450 (CYP) family of enzymes. One of the problems of direct-acting oral anticoagulants lies in the laboratory assays, as tests to measure drug levels are not well standardized and are not suitable for most centers. With rivaroxaban, PT is more sensitive than PTT; however, the results are dependent on the PT reagent used and other test with more specify have been introduced into the clinical practice. Conclusion: It is pivotal that all clinicians who are treating patients with direct-acting oral anticoagulants become aware of relevant drug-drug interactions, as well as of the current limited possibilities to assess the level of anticoagulation.

Drug-drug interaction direct oral anticoagulants.

References (20)

  1. 1 Prevention of Venous Thromboembolism [DOI]
  2. 2 Antithrombotic Therapy for Venous Thromboembolic Disease [DOI]
  3. 3 The Pharmacology and Management of the Vitamin K Antagonists [DOI]
  4. 4 Antithrombotic Therapy for Venous Thromboembolic Disease [DOI]
  5. 5 Safety, pharmacodynamics, and pharmacokinetics of BAY 59-7939—an oral, direct Factor Xa inhibitor—after multiple dosing in healthy male subjects [DOI]
  6. 6 Antithrombotic and Thrombolytic Therapy for Ischemic Stroke [DOI]
  7. 7 Antithrombotic and Thrombolytic Therapy for Ischemic Stroke [DOI]
  8. 8 EHRA Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary [DOI]
  9. 9 Metabolism and Excretion of Rivaroxaban, an Oral, Direct Factor Xa Inhibitor, in Rats, Dogs, and Humans [DOI]
  10. 10 Safety, Tolerability, Pharmacodynamics, and Pharmacokinetics of Rivaroxaban—an Oral, Direct Factor Xa Inhibitor—Are Not Affected by Aspirin [DOI]
  11. 11 Rivaroxaban (BAY 59‐7939) – an oral, direct Factor Xa inhibitor – has no clinically relevant interaction with naproxen [DOI]
  12. 12 Population pharmacokinetics and pharmacodynamics of rivaroxaban in patients with non‐valvular atrial fibrillation: Results from ROCKET AF [DOI]
  13. 13 Pharmacokinetic and Pharmacodynamic Drug Interactions With New Oral Anticoagulants [DOI]
  14. 14 Combined Administration of Antibiotics and Direct Oral Anticoagulants: A Renewed Indication for Laboratory Monitoring? [DOI]
  15. 15 Absence of Clinically Relevant Interactions between Rivaroxaban - an Oral, Direct Factor Xa Inhibitor - and Digoxin or Atorvastatin in Healthy Subjects [DOI]
  16. 16 Clinical challenges related to novel oral anticoagulants: drug-drug interactions and monitoring [DOI]
  17. 17 Clinical management of rivaroxaban-treated patients [DOI]
  18. 18 An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation [DOI]
  19. 19 Functional signatures identified in B-cell non-Hodgkin lymphoma profiles [DOI]
  20. 20 Antithrombotic therapy and the invasive cardiac catheterization management strategy: the intracoronary stenting with antithrombotic regimen cooling-off trial.

Cited by 1

Is Anticoagulation with Novel Oral Anticoagulants an Effective Treatment for Tuberculosis Patients not Achieving a Therapeutic Range with Vitamin K Antagonists? A Systematic Review

Marco Fiore, Alberto Enrico Maraolo, Paolo Chiodini · Cardiovascular & Haematological Disorders - Drug Targets · 2017

Related research

Article metrics

Real usage data collected on this platform.

44

Page views

0

PDF downloads

7

Outbound clicks

1

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.