This is the first study that demonstrates the perpetrator characteristics of all available oral azole antifungal drugs on three microdosed oral factor Xa inhibitors (FXaIs).

Of the azoles, ketoconazole showed the strongest inhibitory effects on all three oral FXaIs; however, the largest clearance reduction (46%) was observed with edoxaban following coadministration with posaconazole.

These drug–drug interactions will be clinically manageable, with a dose reduction by half, at the most, although some combinations are not recommended by the manufacturers.