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Carbamazepine and DOAC — GPhC CRA MCQ

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HardDrug InteractionsCarbamazepine and DOACGPhC CRA

A patient taking carbamazepine for trigeminal neuralgia is prescribed apixaban 5 mg twice daily for new AF. Renal function is normal and weight is 80 kg. What is the most important interaction to flag?

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Correct answer: C — Carbamazepine may reduce apixaban exposure and anticoagulant effect

Carbamazepine is a strong enzyme inducer and can reduce exposure to some DOACs, risking treatment failure. This is particularly important in stroke prevention for AF. The pharmacist should contact the prescriber to consider an alternative anticoagulation strategy.

Reference: BNF