Major
Established
설명
Fluconazole increases apixaban plasma concentrations significantly through dual CYP3A4 and P-gp inhibition, raising bleeding risk.
기전
Apixaban is metabolised by CYP3A4 and transported by P-glycoprotein; fluconazole inhibits both pathways, substantially increasing apixaban exposure.
임상적 중요성
Apixaban AUC may increase ~100%; dose-dependent increase in bleeding events has been observed.
관리 방법
Reduce apixaban dose when combined with dual CYP3A4/P-gp inhibitors; monitor closely for bleeding symptoms. Consider alternative antifungals.