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DOAC and carbamazepine — GPhC CRA MCQ

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HardDrug InteractionsDOAC and carbamazepineGPhC CRA

A patient taking apixaban for AF is newly prescribed carbamazepine for trigeminal neuralgia. What is the most important interaction to flag?

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Correct answer: C — Carbamazepine may reduce apixaban exposure and anticoagulant effect

Carbamazepine is a strong enzyme inducer and can reduce exposure to some DOACs, risking loss of anticoagulant effect. This is clinically important because inadequate anticoagulation in AF increases stroke risk. The prescriber should review anticoagulant choice and neuralgia treatment. INR is not used for routine apixaban dose adjustment.

Reference: BNF