Compatibility «Apixaban» and «Amiodarone»

• Interactions Apixaban with Amiodarone

  • Dangerous interactions
    • ⓘ Dose adjustment of apixaban in combination with ketoconazole is not required, however, apixaban should be used with caution in patients receiving systemic therapy with azole antifungal agents, in particular ketoconazole, or other potent inhibitors of the CYP3A4 isoenzyme and P-glycoprotein.
    • ⓘ The combination of apixaban with rifampicin (a powerful inducer of the CYP3A4 isoenzyme and P-glycoprotein) led to a decrease in the average values of AUC and C_max apixaban by approximately 54 and 42%, respectively.
    • ⓘ Apparently, the combination of apixaban with other powerful inducers of the CYP3A4 isoenzyme and P-glycoprotein (in particular phenytoin, carbamazepine, phenobarbital or St. John's wort preparations) may also lead to a decrease in the concentration of apixaban in blood plasma.
  • Negative interactions
    • ⓘ Inhibitors of the CYP3A4 isoenzyme and P-glycoprotein.
    • ⓘ The combination of apixaban with ketoconazole (at a dose of 400 mg 1 time per day), which is a powerful inhibitor of both the CYP3A4 isoenzyme and P-glycoprotein, led to an increase in the average AUC of apixaban by 2 times and the average value of C_max by 1.6 times.
    • ⓘ Drugs that moderately reduce the rate of apixaban elimination or inhibit the CYP3A4 isoenzyme and/or P-glycoprotein are expected to increase the concentration of apixaban in blood plasma to a lesser extent.
    • ⓘ For example, diltiazem (a moderate inhibitor of the CYP3A4 isoenzyme and a weak inhibitor of P-glycoprotein) at a dose of 360 mg 1 time per day led to an increase in the average AUC values of apixaban by 1.4 times and the average values with _max - by 1.3 times.
    • ⓘ Dose adjustment of apixaban when combined with moderate inhibitors of the CYP3A4 isoenzyme and / or P-glycoprotein is not required.
  • Unclear interactions
    • ⓘ Inducers of the CYP3A4 isoenzyme and P-glycoprotein.
    • ⓘ In vitro studies, apixaban did not inhibit the activity of CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2D6 or CYP3A4 isoenzymes (inhibitory concentration (50'>IC₅₀) >45 mmol/L), however, a weak suppression of activity was found the CYP2C19 isoenzyme (IC₅₀ >20 mmol/l) with apixaban at a concentration significantly exceeding C_max in blood plasma during its clinical use.
    • ⓘ Apixaban is not an inducer of the isoenzymes CYP1A2, CYP2B6, CYP3A4/5 in concentrations up to 20 mmol/L.

Decoding the colors of interactions and contraindications

Dangerous	—	a pronounced negative interaction or contraindication.
Negative	—	negative interaction or side effect that may reduce effectiveness.
Positive	—	the interaction can SOMETIMES be used as a positive (often a dose adjustment is needed), or it is an indication of the drug.
No	—	the drugs do NOT interact, which is separately indicated in the instructions.
Unclear	—	the system failed to pre-assess the danger.

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Additional information

• Kiberis checks interactions and evaluates drug compatibility for free online right in the instructions thanks to the latest artificial intelligence technologies. The accuracy of finding is more than 95%, the accuracy of the hazard assessment is more than 80%. The online medical service takes into account all the drug groups of the selected drugs and all their components. And since the database contains 25,000 drugs with detailed instructions, not every pharmacologist can compete with our artificial intelligence. List of popular interactions.
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• The use of information about interactions is only possible as an introduction. This information should not be used to adjust therapy without consulting a specialist.
• The article is written: artificial intelligence Kiberis
• Sources: official instructions for medicines and their active substances, as well as inter-group interactions described in medical studies and textbooks.
• Total analyzed: 169,994,378 possible combinations of drugs and their components were found 412,530 interacting combinations.
• Medicine section: Standard evidence-based medicine
• The date of the last update of the interaction database: 2024-12-19

Category - medicine