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DOAC and carbamazepine — GPhC CRA MCQ

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ModerateDrug InteractionsDOAC and carbamazepineGPhC CRA

A patient taking apixaban for atrial fibrillation is prescribed carbamazepine for trigeminal neuralgia. The prescriber has not mentioned anticoagulation review. What is the most important interaction to flag?

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Correct answer: B — Carbamazepine can reduce apixaban exposure and anticoagulant effect

Carbamazepine is a strong enzyme inducer and can reduce exposure to some direct oral anticoagulants. Reduced anticoagulant effect may increase stroke or thrombosis risk. The pharmacist should query the combination and ensure an anticoagulation plan is made.

Reference: BNF