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Rifampicin and DOAC — GPhC CRA MCQ

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HardDrug InteractionsRifampicin and DOACGPhC CRA

A patient taking apixaban for atrial fibrillation is started on rifampicin for a mycobacterial infection. The TB clinic asks the community pharmacist to flag relevant issues. What is the most important interaction to flag?

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

Rifampicin is a potent enzyme and transporter inducer and can reduce exposure to some direct oral anticoagulants. Reduced anticoagulant effect may increase stroke or thrombosis risk. Anticoagulation should be reviewed by the specialist team.

Reference: BNF