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Apixaban and clarithromycin — GPhC CRA MCQ

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ModerateDrug InteractionsApixaban and clarithromycinGPhC CRA

A patient on apixaban for atrial fibrillation receives clarithromycin for pneumonia. They have easy bruising at baseline. What is the most important interaction to flag?

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Correct answer: D — Increased apixaban exposure and bleeding risk

Clarithromycin can inhibit pathways involved in apixaban clearance, increasing bleeding risk. The interaction should be assessed before supply. In this scenario, the correct option is increased apixaban exposure and bleeding risk. 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