Major
Established
描述
Cyclosporine, a strong dual inhibitor of CYP3A4 and P-glycoprotein, substantially increases rivaroxaban exposure and bleeding risk.
机制
Rivaroxaban depends on CYP3A4 for metabolism and P-gp for intestinal efflux; cyclosporine inhibits both, increasing rivaroxaban AUC by up to 50%.
临床意义
This combination is generally contraindicated in post-transplant patients who may also have organ-specific bleeding risks.
处理措施
Avoid combination; consider alternative anticoagulation strategies in transplant recipients requiring anticoagulation.