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Rifampicin and apixaban — GPhC CRA MCQ

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HardDrug InteractionsRifampicin and apixabanGPhC CRA

A 58-year-old man has a prescription for rifampicin for prosthetic joint infection. He takes apixaban 5mg twice daily for AF and diltiazem modified-release for rate control. The infection plan is for six weeks. 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 inducer and can reduce exposure to some oral anticoagulants. The six-week course makes this sustained rather than trivial. The pharmacist should urgently flag to the prescriber so anticoagulation strategy is reviewed.

Reference: BNF