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

Autor: Stefano Lancellotti, Erica De Candia, Raimondo De Cristofaro, Leonardo Di Gennaro
Rok vydání: 2019
Předmět:
Drug
Personalized oral anticoagulant therapy
medicine.medical_specialty
Pyridines
Pyridones
Carbamazepin
media_common.quotation_subject
030204 cardiovascular system & hematology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Edoxaban
Atrial Fibrillation
Humans
Medicine
Drug Interactions
030212 general & internal medicine
Precision Medicine
Intensive care medicine
media_common
Ischemic Attack
Transient
business.industry
Potential risk
Settore MED/09 - MEDICINA INTERNA
Atrial fibrillation
Hematology
Carbamazepine
medicine.disease
Anti-Xa activity
DOAC interaction
Thiazoles
chemistry
Ischemic Attack
Transient
Concomitant
Direct oral anticoagulant
Anticonvulsants
Drug Monitoring
Factor Xa Inhibitors
Pyrazoles
Oral anticoagulant
Apixaban
Cardiology and Cardiovascular Medicine
business
medicine.drug
Zdroj: Journal of Thrombosis and Thrombolysis. 48:528-531
ISSN: 1573-742X
0929-5305
Popis: 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.
Databáze: OpenAIRE
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