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Carbamazepine and DOAC — GPhC CRA MCQ

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HardDrug InteractionsCarbamazepine and DOACGPhC CRA

A patient taking carbamazepine for epilepsy is prescribed apixaban for atrial fibrillation. The GP asks whether the combination is acceptable. What is the most important interaction to flag?

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Correct answer: E — Carbamazepine may reduce apixaban exposure and anticoagulant efficacy

Carbamazepine is a strong enzyme inducer and can reduce exposure to some direct oral anticoagulants. This may reduce anticoagulant efficacy and increase stroke risk. The prescriber should consider specialist guidance and alternative anticoagulation if needed. Food timing does not resolve the mechanism.

Reference: BNF; SPS interactions