Apixaban; Rivaroxaban/P-gp and Strong CYP 3A4 Inducers
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Some medicines, including carbamazepine, phenytoin, rifampin, and St. John's wort, may cause your body to process apixaban and rivaroxaban more quickly.
What might happen:
The effects of apixaban and rivaroxaban may decrease and increase your risk for blood clots. If you stop taking your other medicine, there is an increased chance for bleeding.
What you should do about this interaction:
Contact your healthcare professionals (e.g. doctor or pharmacist) about taking these two medicines together or if you have taken carbamazepine, phenytoin, rifampin, or St. John's wort in the previous two weeks. Your dose of apixaban or rivaroxaban may need adjusting, especially if your doctor stops your other medicine. If you experience bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it.Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Eliquis (apixaban) Australian prescribing information. Bristol-Myers Squibb Australia Pty. Ltd. July 21, 2011.
2.Eliquis (apixaban) Canadian prescribing information. Bristol-Myers Squibb-Pfizer December, 13, 2011.
3.Eliquis (apixaban) UK summary of product characterstics. Bristol-Myers Squibb/Pfizer EEIG, Bristol-Myers Squibb House November 19, 2012.
4.Eliquis (apixaban) US prescribing information. Bristol-Myers Squibb Company December, 2012.
5.Xarelto (rivaroxaban) US prescribing information. Janssen Pharmaceuticals, Inc. July, 2011.
