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Carbamazepine and apixaban — GPhC CRA MCQ

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HardDrug InteractionsCarbamazepine and apixabanGPhC CRA

A 33-year-old man with epilepsy takes carbamazepine modified-release 400mg twice daily. He is prescribed apixaban for a provoked DVT after surgery. His renal and liver function are normal. What is the most important interaction to flag?

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Reveal the answer and explanation

Correct answer: D — Carbamazepine may reduce apixaban exposure and increase thrombosis risk.

Carbamazepine is a strong enzyme inducer and can reduce exposure to some direct oral anticoagulants, risking treatment failure. In a patient being treated for DVT, reduced anticoagulant effect is clinically important. The prescriber should review the anticoagulant choice.

Reference: https://www.pharmacyregulation.org/registration-assessment#stage-8-order-91