Rivaroxaban and selective serotonin reuptake inhibitors: Bleeding risk resulting from their concomitant use.
| Autor: | Bruni-Montero MÁ; Department of Pharmacy, Hospital Universitario 12 de Octubre, Madrid. Spain.. miguelangel.bruni@salud.madrid., Caro-Teller JM; Department of Pharmacy, Hospital Universitario 12 de Octubre, Madrid. Spain.. josemanuel.caro@salud.madrid.org., Hernández-Ramos JA; Department of Pharmacy, Hospital Universitario 12 de Octubre, Madrid. Spain.. jhernandezr@salud.madrid.org., Rosas-Espinoza C; Department of Pharmacy, Hospital Enfermera Isabel Zendal, Madrid. Spain. cristian.rosas@salud.madrid.org., Canales-Siguero D; Department of Pharmacy, Hospital Universitario 12 de Octubre, Madrid. Spain.. mcanales@salud.madrid.org., Ferrari-Piquero JM; Department of Pharmacy, Hospital Universitario 12 de Octubre, Madrid. Spain.. josemiguel.ferrari@salud.madrid.org. |
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| Jazyk: | angličtina |
| Zdroj: | Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria [Farm Hosp] 2021 Dec 01; Vol. 46 (1), pp. 10-14. Date of Electronic Publication: 2021 Dec 01. |
| Abstrakt: | Objective: The combination of selective serotonin reuptake inhibitors with rivaroxaban may result in a dual interaction (pharmacokinetic and pharmacodynamic) depending on the type of selective serotonin reuptake inhibitor employed (CYP3A4-inhibiting vs. non-CYP3A4 inhibiting). The purpose of this study was to use real world data to determine if the type of selective serotonin reuptake inhibitor used plays a role in the risk and severity of bleeding in patients receiving rivaroxaban. Method: This was a single-center retrospective longitudinal observational study carried out between January 2016 and February 2020 in patients aged 18 years or older treated concurrently with rivaroxaban (prescribed for treatments) and a selective serotonin reuptake nhibitor. Patients were divided into two groups according to the selective serotonin reuptake inhibitor they received, i.e., a CYP3A4 inhibitor (group 1): sertraline, fluoxetine and paroxetine, or a non-CYP3A4 inhibitor (group 2): citalopram and escitalopram. We analyzed the bleeding events and everity, the daily dose of rivaroxaban used and the medication administered concomitantly. Results: A total of 146 patients were included (89 in group 1 and 57 in group 2) and 35 bleeding events (24% of patients) were identified, of which 12 were major and 23 were minor. The bleeding rate was higher in group 1 (25.8% vs 21.0%) but there were no differences in major bleeding (10.1% vs 5.3%; p = 0.235) or minor bleeding (13.5% vs 15.8%; p = 0.496). The bleeding rate with a daily rivaroxaban dose of 20 mg was 9% (8/89) in group 1 and 14% (8/57) in group 2 (p = 0.2137), as compared with 16.9% (15/89) in group 1 versus 7% (4/57) in group 2 (p = 0.042) for a daily 15 mg dose. Conclusions: Although the type of selective serotonin reuptake inhibitor used concurrently with rivaroxaban was not found to influence the patients' bleeding risk, a significant increase in the risk of bleeding was bserved based on the dose of rivaroxaban used. (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.) |
| Databáze: | MEDLINE |
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