A Dangerous and Unrecognized Interaction of Apixaban

被引：2

作者：

Ammar, Hussam ^{[1
]}

Govindu, Rukma R. ^{[2
,3
]}

机构：

[1] MedStar Washington Hosp Ctr, Internal Med, Washington, DC 20010 USA

[2] Univ Texas Hlth Sci Ctr Houston, Internal Med, Houston, TX 77030 USA

[3] Univ Texas Mcgovern Med Sch Houston, Internal Med, Houston, TX USA

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2021年 / 13卷 / 11期

关键词：

hiv; cobicistat; cyp3a4; inhibitor; cytochrome; 450; drug interaction; apixaban; vascular procedure;

D O I：

10.7759/cureus.19688

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Direct oral anticoagulants (DOACs) drug-to-drug interactions are underrecognized by clinicians. Apixaban has cytochrome 450 (CYP) mediated metabolism (primarily by CYP3A4). Strong inducers and inhibitors of this enzyme may cause variations in the blood level of apixaban. This report presents a patient who received a femoral artery stent and developed a large retroperitoneal hemorrhage after she was prescribed apixaban in addition to her antiretroviral therapy (AVT) regimen that included cobicistat, a strong CYP3A4 inhibitor. The patient was managed conservatively, and a repeat computed tomography scan in a subsequent admission revealed near resolution of the hematoma. The treating physicians realized that apixaban should not be prescribed with a potent CYP3A4 inhibitor like cobicistat and discontinued it.

引用

页数：5

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