Rivaroxaban and azole antifungal — GPhC CRA MCQ
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Correct answer: E — Fluconazole may increase rivaroxaban exposure and bleeding risk
Azole antifungals can increase exposure to some DOACs through metabolic and transporter inhibition, increasing bleeding risk. Reduced renal function and existing bruising increase concern. The patient should be referred for assessment and a safer antifungal approach. The interaction is not loss of anticoagulant effect.
Reference: BNF Rivaroxaban interactions; BNF Fluconazole