https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=20048
Document made available to the pharmacist to communicate a drug interaction to the doctor.
DOWNLOADAtazanavir can decrease the P-gp and increase the plasma concentration of Edoxaban.
–
–
–
Possible increase of adverse effects.
A decrease in the dose should be considered.
Monitor closely clinical efficacy and appearance of adverse effects.
See comments.
–
Effectiveness and safety (signs and symptoms of bleeding : anemia, hematoma, hematuria, epistaxis, gastrointestinal disorders, urinary and digestive haemorrhage) and, particularly in patients with bleeding risk factors (old person, low body weight, impaired kidney function).
–
–
Ref #3396 : In a study, a single concomitant dose of edoxaban 60 mg with ketoconazole 400 mg QD, increased edoxaban AUC and Cmax by 87% and 89%, respectively.
Canadian product monograph states that HIV protease inhibitors such as darunavir/ritonavir or lopinavir/ritonavir can inhibit P-gp and potentially increase edoxaban exposure by 1.5 to 2-fold. They also say that concomitant use with potent P-gp inhibitors, such as ketoconazole or erythromycin, requires edoxaban dose reduction to 30 mg QD.
Ref #3527 : However, according to clinical information, when performing this dose reduction in the presence of P-gp inhibitors, it was observed in the ENGAGE AF-TIMI study that the plasma levels of edoxaban were lower compared to patients who were receiving the standard dose. Consequently, no dose reduction is recommended for concomitant P-gp inhibitor use.