Managing Direct Oral Anticoagulants in Patients With Antiepileptic Medication

Gil Dagan, Amichai Perlman, Sarit Hochberg-Klein, Yosef Kalish, Mordechai Muszkat*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Current guidance recommends avoiding concomitant use of direct-acting oral anticoagulants and enzyme-inducing antiepileptic drugs because of theoretical drug interactions potentially leading to subtherapeutic drug concentrations and treatment failure. We describe a case documenting a significant interaction between phenobarbital and rivaroxaban, and then apixaban. This case illustrates and supports the concerns regarding concomitant use of these medications. Additionally, in this case the interaction was managed with concentration-guided dosing of apixaban, suggesting this approach may represent a feasible strategy for managing patients requiring treatment with direct-acting oral anticoagulants and enzyme-inducing antiepileptic drugs.

Original languageAmerican English
Pages (from-to)1534.e1-1534.e3
JournalCanadian Journal of Cardiology
Volume34
Issue number11
DOIs
StatePublished - Nov 2018

Bibliographical note

Publisher Copyright:
© 2018 Canadian Cardiovascular Society

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