Drug Interaction Report

MONITOR CLOSELY: Coadministration with inducers of P-glycoprotein (P-gp) may reduce the bioavailability of edoxaban, which is a substrate of the efflux transporter. According to the product labeling, the potent P-gp inducer rifampin decreased single-dose edoxaban systemic exposure (AUC) by approximately 35%.

MANAGEMENT: Caution is advised if edoxaban is used with P-gp inducers. Pharmacologic response to edoxaban should be monitored more closely whenever a P-gp inducer is added to or withdrawn from therapy, and the edoxaban dosage adjusted as necessary.

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.