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DOAC and strong enzyme inducer — GPhC CRA MCQ

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HardDrug InteractionsDOAC and strong enzyme inducerGPhC CRA

A patient taking apixaban for atrial fibrillation is prescribed carbamazepine for trigeminal neuralgia. The GP asks the pharmacist to check interactions. What is the most important interaction to flag?

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Correct answer: D — 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. The combination often requires avoidance or specialist advice. Enzyme induction is not solved by changing administration time.

Reference: BNF