Bungard Tammy J, Roberts R Neil
Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Division of Neurology, University of Alberta, Edmonton, Alberta, Canada.
CJC Open. 2020 May 1;2(5):423-425. doi: 10.1016/j.cjco.2020.04.009. eCollection 2020 Sep.
Avoidance of apixaban with carbamazepine (CBZ) is recommended owing to an anticipated reduction in apixaban concentration, although this drug interaction is poorly described. We report a case wherein apixaban concentration was measured before and 2 weeks after CBZ. Apixaban concentrations were substantially reduced; hence, the dose of apixaban was doubled alongside a small increase in CBZ. Subsequent apixaban concentrations were essentially unchanged. This extent of reduction in apixaban concentration appears to be related to the dose of CBZ, with the interaction occurring over 2-4 weeks. This combination should be avoided unless apixaban concentrations can be assessed using a calibrated assay.
由于预计阿哌沙班浓度会降低，故建议避免阿哌沙班与卡马西平（CBZ）联用，尽管这种药物相互作用的描述较少。我们报告了一例在服用CBZ前及服用后2周测量阿哌沙班浓度的病例。阿哌沙班浓度大幅降低；因此，阿哌沙班剂量加倍，同时CBZ剂量略有增加。随后阿哌沙班浓度基本未变。阿哌沙班浓度降低的程度似乎与CBZ剂量有关，相互作用发生在2 - 4周内。除非能用校准检测法评估阿哌沙班浓度，否则应避免这种联合用药。
