Apixaban-carbamazepine interaction — GPhC CRA MCQ
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Correct answer: A — Carbamazepine lowers apixaban exposure, increasing thromboembolic risk
Carbamazepine strongly induces CYP3A4 and P-glycoprotein and can substantially reduce apixaban exposure. The combination should be queried because loss of anticoagulant efficacy cannot be managed by routine INR or unsupervised apixaban dose escalation.
Reference: BNF: apixaban: https://bnf.nice.org.uk/drugs/apixaban/