Major
Established
Deskripsi
Cyclosporine dramatically increases dabigatran exposure through P-gp inhibition, raising the risk of serious or life-threatening bleeding.
Mekanisme
Dabigatran etexilate is a P-gp substrate; cyclosporine's potent P-gp inhibition increases dabigatran bioavailability by up to 200%.
Signifikansi Klinis
Contraindicated in the EU; FDA label includes a strong warning. Bleeding risk is substantially and unpredictably elevated.
Penatalaksanaan
Contraindicated; avoid combination entirely. Select an alternative anticoagulant (e.g., a low-molecular-weight heparin) in patients requiring cyclosporine.