Descrição

Fluconazole increases apixaban plasma concentrations significantly through dual CYP3A4 and P-gp inhibition, raising bleeding risk.

Mecanismo

Apixaban is metabolised by CYP3A4 and transported by P-glycoprotein; fluconazole inhibits both pathways, substantially increasing apixaban exposure.

Significância Clínica

Apixaban AUC may increase ~100%; dose-dependent increase in bleeding events has been observed.

Conduta

Reduce apixaban dose when combined with dual CYP3A4/P-gp inhibitors; monitor closely for bleeding symptoms. Consider alternative antifungals.

Aviso Médico

This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.

Data sources: ChEMBL, PubChem, DailyMed.