The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine

Concomitant use of apixaban and carbamazepine (CBZ) is not recommended due to an anticipated reduction in apixaban concentration, although few case reports describe this interaction. We report a case of initiating apixaban 10 mg twice daily (BID), in a patient stabilized on CBZ 600 mg BID that was g...

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Detalles Bibliográficos
Autores principales: Chadha, Ayush, Lopaschuk, David, Ackman, Margaret L., Bungard, Tammy J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039551/
https://www.ncbi.nlm.nih.gov/pubmed/35495866
http://dx.doi.org/10.1016/j.cjco.2021.12.012
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author Chadha, Ayush
Lopaschuk, David
Ackman, Margaret L.
Bungard, Tammy J.
author_facet Chadha, Ayush
Lopaschuk, David
Ackman, Margaret L.
Bungard, Tammy J.
author_sort Chadha, Ayush
collection PubMed
description Concomitant use of apixaban and carbamazepine (CBZ) is not recommended due to an anticipated reduction in apixaban concentration, although few case reports describe this interaction. We report a case of initiating apixaban 10 mg twice daily (BID), in a patient stabilized on CBZ 600 mg BID that was guided by prior experience. Apixaban concentrations were substantially elevated with initial empiric dosing; apixaban dosing of 7.5 mg BID was eventually implemented. This case highlights the fact that the degree of induction by CBZ can vary, regardless of the dose, and requires clinicians to be cautious when applying prior experiences with patients to new patients.
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spelling pubmed-90395512022-04-27 The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine Chadha, Ayush Lopaschuk, David Ackman, Margaret L. Bungard, Tammy J. CJC Open Case Report Concomitant use of apixaban and carbamazepine (CBZ) is not recommended due to an anticipated reduction in apixaban concentration, although few case reports describe this interaction. We report a case of initiating apixaban 10 mg twice daily (BID), in a patient stabilized on CBZ 600 mg BID that was guided by prior experience. Apixaban concentrations were substantially elevated with initial empiric dosing; apixaban dosing of 7.5 mg BID was eventually implemented. This case highlights the fact that the degree of induction by CBZ can vary, regardless of the dose, and requires clinicians to be cautious when applying prior experiences with patients to new patients. Elsevier 2022-01-07 /pmc/articles/PMC9039551/ /pubmed/35495866 http://dx.doi.org/10.1016/j.cjco.2021.12.012 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Chadha, Ayush
Lopaschuk, David
Ackman, Margaret L.
Bungard, Tammy J.
The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine
title The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine
title_full The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine
title_fullStr The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine
title_full_unstemmed The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine
title_short The Problem With Predictions: A Cautionary Tale of Empirically Adjusting Apixaban Dosing With Carbamazepine
title_sort problem with predictions: a cautionary tale of empirically adjusting apixaban dosing with carbamazepine
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039551/
https://www.ncbi.nlm.nih.gov/pubmed/35495866
http://dx.doi.org/10.1016/j.cjco.2021.12.012
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