Figure 3:

Algorithm to screen for significant direct oral anticoagulant drug-drug interactions. AP – Anti-platelet; DDI – drug-drug interaction; DOAC – direct oral anticoagulant drug-drug; CYP – Cytochrome P450; NSAID – Non-steroidal anti-inflammatory drugs; P-gp – P-glycoprotein; PK – Pharmacokinetic *List is not exhaustive ^†Although clarithromycin is both a strong CYP3A4 and P-gp inhibitor, pharmacokinetic analyses show that it is safe to use with apixaban and rivaroxaban ‡Refers to additive P-gp inhibition from the same interacting agent, or another agent that the patient is taking with either CYP3A4 or P-gp inhibition