OBJECT DRUGS

Anticoagulants, Oral:

• Apixaban (Eliquis)
• Betrixaban (Bevyxxa)
• Dabigatran (Pradaxa)
• Edoxaban (Savaysa)
• Rivaroxaban (Xarelto)

PRECIPITANT DRUGS

P-glycoprotein Inhibitors:

• Amiodarone (Cordarone, etc.)
• Azithromycin (Zithromax, etc.)
• Clarithromycin (Biaxin, etc.)
• Conivaptan (Vaprisol)
• Cyclosporine (Neoral, etc.)
• Daclatasvir (Daklinza)
• Dronedarone (Multaq)
• Erythromycin (E-Mycin, etc.)
• Hydroxychloroquine
• Indinavir (Crixivan)
• Itraconazole (Sporanox, etc.)
• Ketoconazole (Nizoral, etc.)
• Ledipasvir (Harvoni)
• Nelfinavir (Viracept)
• Paritaprevir (Technivie)
• Posaconazole (Noxafil)
• Propafenone (Rythmol, etc.)
• Quinidine (Quinidex)
• Ranolazine (Ranexa)
• Ritonavir (Norvir)
• Saquinavir (Invirase)
• Sunitinib (Sutent)
• Tacrolimus (Prograf, etc.)
• Tamoxifen (Nolvadex)
• Telaprevir (Incivek)
• Telithromycin (Ketek)

Comment:

Inhibitors of P-glycoprotein increase the absorption of the pro-drug dabigatran etexilate, potentially increasing the concentration of the active drug dabigatran. Since P-glycoprotein inhibitors can increase the concentration of these anticoagulants; monitor for increased anticoagulation effects.

Class 3: Assess Risk & Take Action if Necessary

• Circumvent/Minimize:Administration of dabigatran at least 2 hours before the P-glycoprotein inhibitor should minimize the effect on the absorption of dabigatran etexilate.
• Monitor: Monitor for altered anticoagulant effect if one of these P-glycoprotein inhibitors is initiated, discontinued or changed in dosage; adjustments of anticoagulant dosage may be needed.