Supratheraputic rivaroxaban levels: A persistent drug‐drug interaction after discontinuation of amiodarone

Autor:	Esther Agnete Jensen, Britt Falskov, Mikkel Helleberg Dorff, Kenneth Skov
Rok vydání:	2020
Předmět:	Pharmacology medicine.medical_specialty Rivaroxaban business.industry Increased inr Drug-drug interaction Renal function General Medicine Toxicology Amiodarone 030226 pharmacology & pharmacy Discontinuation 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Internal medicine medicine Medical history business 030217 neurology & neurosurgery medicine.drug
Zdroj:	Basic & Clinical Pharmacology & Toxicology. 127:351-353
ISSN:	1742-7843 1742-7835
DOI:	10.1111/bcpt.13419
Popis:	We report the case of an 88-year old woman referred for evaluation of increased INR. Surprisingly supratherapeutic levels of rivaroxaban was detected. Upon scrutiny of the patient's medical history, a drug-drug interaction between amiodarone and rivaroxaban persisting 3 weeks after cessation of amiodaron remains the prime suspect causing the clinical picture. Both INR and rivaroxaban levels returned to normal within 3 days of cessation of rivaroxaban. The case highlights that rivaroxaban, although highly variably, does affect INR. Furthermore, it highlights that the potential for DDIs involving amiodarone may persists for weeks or months after discontinuation. Amiodarone is predicted to increase rivaroxaban exposure, through inhibition of rivaroxaban elimination via CYP3A4 and P-gp. Elderly patients and patients with declining renal function are especially at risk of increased rivaroxaban exposure when a DDI with amiodarone occurs.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::c7143a19c9f033af92f7e94ef35db81e https://doi.org/10.1111/bcpt.13419 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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