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Carbamazepine and DOAC — GPhC CRA MCQ

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HardDrug InteractionsCarbamazepine and DOACGPhC CRA

A patient taking carbamazepine is prescribed rivaroxaban for atrial fibrillation after hospital discharge. What is the most important interaction to flag?

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Correct answer: E — Reduced rivaroxaban exposure from enzyme induction

Carbamazepine is a strong enzyme inducer and can reduce DOAC concentrations. This may compromise anticoagulant efficacy and requires specialist review. In this scenario, the correct option is reduced rivaroxaban exposure from enzyme induction. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF; Stockley's Drug Interactions