TABLE IV.

Common drug–drug interactions with direct factor Xa inhibitors^24–27

Drug class and name	Interaction effect
	Edoxabana	Rivaroxabanb	Apixabanb
Antimitotic agents
Vinblastine	↓	↓	↓
Anti-mycotic agents
Azithromycin	↑	↑	↑
Clarithromycin	↑	↑	↑
Erythromycin	↑	↑	↑
Itroconazole	↑	↑	↑
Ketoconazole	↑	↑	↑
Posaconazole	—	↑	↑
Voriconazole	—	↑	↑
Anthracyclines
Doxorubicin	↓	↓	↓
Hormonal agents
Tamoxifen	↑	↑	↑
Immune-modulating agents
Cyclosporine	↑	↑	↑
Dexamethasone	↓	↓	↓
Tacrolimus	↑	↑	↑
Protease inhibitors
Indinavir	↑	↑	↑
Nelfinavir	↑	↑	↑
Ritonavir	↑	↑	↑
Saquinavir	↑	↑	↑
Tyrosine kinase inhibitors
Imatinib	—	↓	↓
Lapatinib	↑	↑	↑
Nilotinib	↑	↑	↑
Sunitinib	↑	↑	↑

^aSubstrate of P-glycoprotein.

^bSubstrate of P-glycoprotein and CYP3A4 (cytochrome P450 3A4).

↑ = increases plasma factor Xa through P-glycoprotein or CYP3A4 inhibition; ↓ = decreases plasma factor Xa through P-glycoprotein or CYP3A4 induction; — = no effect on plasma factor Xa.