Table 3.
Expected interactions between non‐vitamin K oral anticoagulants and antiretroviral drugs
| Antiretroviral drugs | Apixaban | Dabigatran | Edoxaban | Rivaroxaban |
|---|---|---|---|---|
| Protease inhibitors |
Increase of Apixaban expected with protease inhibitor/cobicistat, protease inhibitor/ritonavir. Use of strong inhibitors of both CYP3A4 and P‐gp contraindicated in SPC. Coadministration not recommended; if necessary, reduce apixaban dose by 50% and monitor for apixaban toxicity 52. |
Limited data but no significant interaction expected. |
Increase of edoxaban expected. Coadministration is not recommended 52. |
Increase of rivaroxaban concentration expected. Coadministration is not recommended 52. Use of strong inhibitors of both CYP3A4 and P‐gp contraindicated in SPC. |
| Non‐nucleoside reverse‐transcriptase inhibitors | Decrease of apixaban possible. | No drug interaction expected. Increase with etravirine possible. | No drug interaction expected. Increase with etravirine possible. | Decrease of rivaroxaban possible. |
| Nucleoside reverse transcriptase inhibitors | No drug interaction expected | |||
| Integrase inhibitors Raltegravir Dolutegravir Bictegravir | No drug interaction expected | |||
| Elvitegravir (always administered with cobicistat) | Drugs concentration increase expected. Coadministration is not recommended 52 | |||
| Cobicistat | Increase of apixaban expected. | Increase in dabigatran concentration by 110% to 127%. Coadministration is not recommended 52. | Increase of edoxaban expected. | Increase of rivaroxaban expected. |
| CCR5 inhibitor | No drug interaction expected | |||
SPC, Summary of product characteristics