Drug Interactions Affecting Oral Anticoagulant Use

[www.ahajournals.org]
[www.practiceupdate.com]


“Direct-acting oral anticoagulants (DOACs) are mainly affected by medications strongly affecting the permeability glycoprotein (P-gp) and, to a lesser extent, strong CYP3A4 inhibitors/inducers. Strong inhibitors/inducers of CYP2C9, CYP3A4, and CYP1A2 may affect warfarin in drug–drug interactions. Strong inducers of CYP3A4 or P-gp should be avoided in all patients taking DOACs, whereas simultaneous use of strong CYP3A4 and P-gp inhibitors should be avoided in patients taking apixaban and rivaroxaban. Dabigatran and edoxaban are affected by P-gp modulation. Concomitant antiplatelet/anticoagulant use confers an additive risk for bleeding.
Minimizing the duration of concomitant anticoagulant/antiplatelet therapy, as indicated by evidence-based clinical guidelines, is the best way to reduce the risk of bleeding.“

I am familiar with this idea but how do you find out if your other drugs fall in this category and how do you "monitor" it? I get how you monitor cumadin (sp?) but not xeralto and eliquis. I know you mentioned this before so I do pop my Prilosec first thing and then my other meds hours later... Interesting my EP didn't know that Prilosec depletes Mg. My functional card. mentioned that. I am still taking it post ablation but then going to try and get off it. I had some terrible GERD for awhile and it is helping... and that's important too but I gave up my low acid decaf even!!! And not doing tomatoes.... spicy.. all my. favorites LOL.

also basically EVERY EP prescribes Prilosec and blood thinner for a month after ablation- so I can't figure it is THAT big of a deal.. I don't know if those fall into above but I really the discussion.



Edited 2 time(s). Last edit at 06/28/2022 11:10AM by bettylou4488.