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Drug-drug interactions and adverse drug reactions with classicand new anticoagulants

V. Tzankova, V. Petrov


Drug interactions and adverse drug effects (ADR) have received much attention because many patients are being hospitalized or remaining hospitalized longer than necessary. Use of multiple drugs (8-12 on average in hospitalized patients) is common in a number of therapeutic regimens. Anticoagulant drugs are among the most commonly implicated medications that cause ADR in hospitalized patients and medication errors involving anticoagulant drugs remain common. Elderly and cardiac patients represent populations at particularly high risk for suffering anticoagulant - associated ARD and drug interactions. In this study we review clinically significant pharmacokinetic and pharmacodynamic drug-drug interactions (DDIs) involving classic and new anticoagulants. A literature search was conducted via PubMed and the Cochrane database to identify drug-drug interaction studies, using the terms drug interactions, adverse drug reactions oral anticoagulants, including dabigatran, rivaroxaban, and apixaban. Articles reviewed focused on drugs affecting the permeability glycoprotein (P-gp) efflux transporter protein and/or cytochrome P (CYP) 450 3A4 enzymes, and pharmacodynamic DDIs when drugs are administered concomitantly.Awareness of drugs that are involved in drug-drug interactions and especially those that alter the function of the P-gp efflux transporter protein and CYP3A4 enzymes and provide adverse effects should enable medical doctors to anticipate and avoid potential DDIs involving the anticoagulants.Key words: antocoagulant therapy, drug interactions, adverse drug reactions





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About The Authors

V. Tzankova

V. Petrov

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