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Drug Interactions of Direct-Acting Oral Anticoagulants

Author

Listed:
  • John Leonard Fitzgerald

    (Gold Coast University Hospital)

  • Laurence Guy Howes

    (Gold Coast University Hospital
    Griffith University)

Abstract

In recent years, new direct-acting oral anticoagulants (DOACs) have been introduced into clinical practice that specifically inhibit either factor Ia or Xa. These drugs have, to a large extent, replaced warfarin for the treatment of venous thrombosis, pulmonary embolism, and non-valvular atrial fibrillation. They have potential advantages over warfarin in providing more stable anticoagulation and the lack of a need for regular venesection to monitor activity. They also have the promise of less drug and food interactions. All of these drugs are substrates for the permeability glycoprotein (P-gp) excretion system, and several are metabolised, in part, by cytochrome P450 (CYP) 3A4. This current article assesses the interactions that do or may occur with the DOACs, particularly with respect to the P-gp and CYP3A4 systems.

Suggested Citation

  • John Leonard Fitzgerald & Laurence Guy Howes, 2016. "Drug Interactions of Direct-Acting Oral Anticoagulants," Drug Safety, Springer, vol. 39(9), pages 841-845, September.
    • Handle: RePEc:spr:drugsa:v:39:y:2016:i:9:d:10.1007_s40264-016-0443-8
    DOI: 10.1007/s40264-016-0443-8
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    Cited by:

    1. Emanuel Raschi & Matteo Bianchin & Milo Gatti & Alessandro Squizzato & Fabrizio De Ponti, 2019. "Comparative Effectiveness and Safety of Direct Oral Anticoagulants: Overview of Systematic Reviews," Drug Safety, Springer, vol. 42(12), pages 1409-1422, December.
    2. Emanuel Raschi & Matteo Bianchin & Walter Ageno & Roberto De Ponti & Fabrizio De Ponti, 2016. "Risk–Benefit Profile of Direct-Acting Oral Anticoagulants in Established Therapeutic Indications: An Overview of Systematic Reviews and Observational Studies," Drug Safety, Springer, vol. 39(12), pages 1175-1187, December.

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