Edoxaban and the Issue of Drug-Drug Interactions: From Pharmacology to Clinical Practice

Corsini, Alberto; Ferri, Nicola; Proietti, Marco; Boriani, Giuseppe

doi:10.1007/s40265-020-01328-6

Cited by 27 publications

(26 citation statements)

References 132 publications

(98 reference statements)

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“…On the other hand, strong P-gp inducers such as rifampicin or hypericum could reduce DOAC concentrations to subclinical dose ( Gong and Kim, 2013 ). However, edoxaban can be coadministered with quinidine, verapamil, and amiodarone at the dose of 60 mg/day and with cyclosporine, dronedarone, erythromycin, and ketoconazole, halving the dose ( Corsini et al, 2020 ).…”

Section: Clinical Indications and Pharmacologymentioning

confidence: 99%

Direct Oral Anticoagulants: From Randomized Clinical Trials to Real-World Clinical Practice

et al. 2021

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Direct oral anticoagulants (DOACs) are a more manageable alternative than vitamin K antagonists (VKAs) to prevent stroke in patients with nonvalvular atrial fibrillation and to prevent and treat venous thromboembolism. Despite their widespread use in clinical practice, there are still some unresolved issues on optimizing their use in particular clinical settings. Herein, we reviewed the current clinical evidence on uses of DOACs from pharmacology and clinical indications to safety and practical issues such as drugs and food interactions. Dabigatran is the DOAC most affected by interactions with drugs and food, although all DOACs demonstrate a favorable pharmacokinetic profile. Management issues associated with perioperative procedures, bleeding treatment, and special populations (pregnancy, renal and hepatic impairment, elderly, and oncologic patients) have been discussed. Literature evidence shows that DOACs are at least as effective as VKAs, with a favorable safety profile; data are particularly encouraging in using low doses of edoxaban in elderly patients, and edoxaban and rivaroxaban in the treatment of venous thromboembolism in oncologic patients. In the next year, DOAC clinical indications are likely to be further extended.

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Section: Clinical Indications and Pharmacologymentioning

confidence: 99%

Direct Oral Anticoagulants: From Randomized Clinical Trials to Real-World Clinical Practice

et al. 2021

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“…В табл. приведена информация об основных межлекарственных взаимодействиях эдоксабана 2 [5,[7][8][9][10]. Состав пищи не оказывает заметного влияния на фармако кинетику эдоксабана.…”

Section: особенности фармакодинамики и фармакокинетики лабораторный unclassified

The role of edoxaban in preventing thromboembolic complications in patients with atrial fibrillation

Шахматова

2020

Aterotromboz

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Edoxaban is a selective direct factor Xa inhibitor. Edoxaban in a dose of 60 mg per day is an effective and safe option in the prevention of thromboembolic complications in patients with nonvalvular atrial fibrillation, including in combination therapy in patients after percutaneous coronary interventions. ENGAGE AF-TIMI 48 is currently the most extensive study comparing direct oral anticoagulants and warfarin in patients with atrial fibrillation, both in terms of number of participants and duration of observation. For edoxaban, an adequate approach to dose reduction has been developed in patients with alikely increase in plasma concentration due to renal impairment, low body weight or inter-drug interactions. Such dose reduction does notlead to an increase in the frequency of ischemic complications.Edoxaban is characterized by an optimal safety profile in patients with chronic moderate kidney disease, a small number of drug interactions and a convenient mode of administration. In patients with atrial fibrillation and concomitant ischemic heart disease, the use of Edoxaban is associated with a decrease in the frequency of myocardial infarctions, as well as strokes and episodes of systemic thromboembolism in comparison with warfarin. The drug can be successfully used as anticoagulant support for cardioversion and catheter ablation for atrial fibrillation.Edoxaban intake does not require routinelaboratory control. In case of unexpected situations (life-threatening bleeding, urgent surgical intervention) in patients receiving edoxaban, to assess the degree of anticoagulation should use the determination of anti-Xa activity. Clinical studies of a specific antidote of edoxaban - andexanet alfa are ongoing. Before approval of the specific antidote in severe andlife-threatening bleedings against the background of edoxaban administration, the use of prothrombin complex concentrate should be considered. Data on the effective and safe use of edoxaban in routine clinical practice have been accumulated.

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“…In contrast with rivaroxaban and apixaban, edoxaban is minimally metabolized by CYP3A4 (<4%) (44). Therefore, the risk of potential interactions of edoxaban with other drugs is low.…”

Section: Potential Drug Interactionsmentioning

confidence: 99%

“…By contrast, when administered with amiodarone or verapamil, no dose adjustment is required. Edoxaban can be safely taken with itraconazole or voriconazole (by halving the dose) (44).…”

Section: Potential Drug Interactionsmentioning

confidence: 99%

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Direct oral anticoagulants: A new chapter in anticoagulation therapy

Stepanović-Petrović¹,

Nastić²

2020

Arhiv za farmaciju

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Thromboembolic events are the leading cause of morbidity and mortality worldwide. From the second half of the 20th century, vitamin K antagonists (VKAs), warfarin and acenocoumarol, were the only anticoagulants taken orally. The major reform in anticoagulation therapy was made by the advent of direct oral anticoagulants (DOACs), about 10 years ago. Direct thrombin inhibitor (dabigatran) and direct inhibitors of factor Xa (rivaroxaban, apixaban, edoxaban, and betrixaban) have demonstrated favorable risk/benefit ratio. Compared to warfarin, DOACs are associated with a predictable pharmacokinetic profile, lower severe bleeding complications, particularly intracranial hemorrhages, and minimal drug interactions. Moreover, DOACs achieve a rapid onset of action and have shown comparable efficacy with warfarin and low molecular weight heparin (LMWH) in clinical trials. As a result, DOACs are now replacing VKAs and LMWH for many indications including stroke and systemic embolism prevention in nonvalvular atrial fibrillation, prevention, and treatment of venous thromboembolism and thromboprophylaxis following total knee/hip replacement surgery. In addition, rivaroxaban (in combination with aspirin alone or aspirin and clopidogrel) is used in the prevention of atherothrombotic events following acute coronary syndrome with elevated cardiac biomarkers. In case of severe bleeding complications under DOACs treatment, antidotes are available; idarucizumab for dabigatran reversal and andexanet alfa for rivaroxaban and apixaban.

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Edoxaban and the Issue of Drug-Drug Interactions: From Pharmacology to Clinical Practice

Cited by 27 publications

References 132 publications

Direct Oral Anticoagulants: From Randomized Clinical Trials to Real-World Clinical Practice

Direct Oral Anticoagulants: From Randomized Clinical Trials to Real-World Clinical Practice

The role of edoxaban in preventing thromboembolic complications in patients with atrial fibrillation

Direct oral anticoagulants: A new chapter in anticoagulation therapy

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