Table 1.
Investigative medications for COVID-19 positive patients and effect on DOAC concentration.
| Medication | Mechanism | Dabigatran | Apixaban | Edoxaban | Rivaroxaban |
|---|---|---|---|---|---|
| Hydroxy-chloroquine | None | - | - | - | - |
| Azithromycin | P-glycoprotein competition | ↑No dose adjustment recommended | ↑VTE:30 mg daily AF: No dose changes |
||
| Remdesivir | Reportedly CYP3A4 | ? | ? | ? | ? |
| Lopinavir/Ritonavir | CYP3A4 Inhibition/P-glycoprotein competition | ↑No dose adjustment recommended, however would avoid if possible | ↑↑50% dose reduction (do not use if patient requires 2.5 mg BID at baseline) | ↑↑Do not co-administer | ↑↑Do not co-administer |
| Tocilizumab | CYP3A4 Inducer (weak) | - | ↓No dose adjustment recommended | - | ↓No dose adjustment recommended |
| Sarilumab | CYP3A4 Inducer | - | ↓No dose adjustment recommended | - | ↓No dose adjustment recommended |
| Favipiravir | CYP2C8 | - | - | - | - |
| Nitazoxanide | Weak CYP2C9 | - | - | - | - |
| Tacrolimus | P-glycoprotein competition in-vitro | - | -/↑ | - | -/↑ |
| Camostat Mesilate | Unknown | ? | ? | ? | ? |