Skip to main content
SpringerLink
Log in

Drug–Drug Interaction with DOACs

  • Chapter
  • First Online:
Direct Oral Anticoagulants

  • 1105 Accesses

Abstract

Despite the relative recent approval, dabigatran, rivaroxaban, apixaban, and edoxaban are spreading in current clinical use, being indicated both for thromboprophylaxis in patients with non-valvular atrial fibrillation (NVAF) and for the treatment and prevention of venous thromboembolism (VTE). In patients with multiple conditions, as in particular NVAF ones or with cancer, the contemporary administration of several drugs can cause relevant drug–drug interactions (DDIs), which can affect drugs’ pharmacokinetics and pharmacodynamics. Usually, all the DOACs are considered to be free of DDIs, notwithstanding this is actually not true, all of them being affected by DDIs with drugs that can influence the activity (induction or inhibition) of P-glycoprotein (P-gp) and Cytochrome P450 isoenzyme (CYP), both responsible for DOACs disposition and metabolism to a different extent. In this chapter, it is described all the relevant drugs categories that have been reported to have shown significant DDIs when administered together with DOACs. The impact on DOACs pharmacokinetic and pharmacodynamic and the evidence for dose adjustment will be also discussed. The information reported in this chapter emphasizes that despite a restrained number of interactions, some strong inhibitors/inducers of P-gp and drug-metabolizing enzymes can affect DOACs concentration, implying the need for a dose adjustment or contraindication. Notwithstanding, the analysis of DOACs DDIs suggests that given the small propensity for interaction of this agents, their use represents an acceptable clinical decision, especially comparing the warfarin DDIs. Still the DDIs can be significant in certain clinical situations so a careful evaluation of DDIs should be made before prescribing a specific DOAC.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agnelli G, Becattini C, Bauersachs R, Brenner B, Campanini M, Cohen A, Connors JM, Fontanella A, Gussoni G, Huisman MV, Lambert C, Meyer G, Munoz A, Abreu J, de Sousa AT, Verso M, Vescovo G, I. Caravaggio Study. Apixaban versus Dalteparin for the treatment of acute venous thromboembolism in patients with cancer: the Caravaggio study. Thromb Haemost. 2018;118(9):1668–78.

    Article  PubMed  Google Scholar 

  • Ay C, Pabinger I, Cohen AT. Cancer-associated venous thromboembolism: burden, mechanisms, and management. Thromb Haemost. 2017;117(2):219–30.

    Article  PubMed  Google Scholar 

  • Boriani G, Diemberger I, Martignani C, Biffi M, Branzi A. The epidemiological burden of atrial fibrillation: a challenge for clinicians and health care systems. Eur Heart J. 2006;27:893–4.

    Article  PubMed  Google Scholar 

  • Boriani G, Proietti M, Laroche C, Fauchier L, Marin F, Nabauer M, Potpara T, Dan GA, Kalarus Z, Diemberger I, Tavazzi L, Maggioni AP, Lip GYH. Contemporary stroke prevention strategies in 11 096 European patients with atrial fibrillation: a report from the EURObservational research Programme on atrial fibrillation (EORP-AF) long-term general registry. Europace. 2018;20(5):747–57.

    Article  PubMed  Google Scholar 

  • Branchetti E, Sainger R, Poggio P, Grau JB, Patterson-Fortin J, Bavaria JE, Chorny M, Lai E, Gorman RC, Levy RJ, Ferrari G. Antioxidant enzymes reduce DNA damage and early activation of valvular interstitial cells in aortic valve sclerosis. Arterioscler Thromb Vasc Biol. 2013;33(2):e66–74.

    Article  CAS  PubMed  Google Scholar 

  • Chang SH, Chou IJ, Yeh YH, Chiou MJ, Wen MS, Kuo CT, See LC, Kuo CF. Association between use of non-vitamin K oral anticoagulants with and without concurrent medications and risk of major bleeding in Nonvalvular atrial fibrillation. JAMA. 2017;318(13):1250–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Coppens M, Eikelboom JW, Hart RG, Yusuf S, Lip GY, Dorian P, Shestakovska O, Connolly SJ. The CHA2DS2-VASc score identifies those patients with atrial fibrillation and a CHADS2 score of 1 who are unlikely to benefit from oral anticoagulant therapy. Eur Heart J. 2013;34(3):170–6.

    Article  CAS  PubMed  Google Scholar 

  • Davidson BL, Verheijen S, Lensing AW, Gebel M, Brighton TA, Lyons RM, Rehm J, Prins MH. Bleeding risk of patients with acute venous thromboembolism taking nonsteroidal anti-inflammatory drugs or aspirin. JAMA Intern Med. 2014;174(6):947–53.

    Article  CAS  PubMed  Google Scholar 

  • Di Minno A, Frigerio B, Spadarella G, Ravani A, Sansaro D, Amato M, Kitzmiller JP, Pepi M, Tremoli E, Baldassarre D. Old and new oral anticoagulants: food, herbal medicines and drug interactions. Blood Rev. 2017;31(4):193–203.

    Article  PubMed  CAS  Google Scholar 

  • El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871–80.

    Article  PubMed  Google Scholar 

  • Ferri N, Bellosta S, Baldessin L, Boccia D, Racagni G, Corsini A. Pharmacokinetics interactions of monoclonal antibodies. Pharmacol Res. 2016;111:592–9.

    Article  CAS  PubMed  Google Scholar 

  • Frost C, Shenker A, Gandhi MD, Pursley J, Barrett YC, Wang J, Zhang D, Byon W, Boyd RA, LaCreta F. Evaluation of the effect of naproxen on the pharmacokinetics and pharmacodynamics of apixaban. Br J Clin Pharmacol. 2014;78(4):877–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Frost C, Song Y, Yu Z, Wang J, Lee LS, Schuster A, Pollack A, LaCreta F. The effect of apixaban on the pharmacokinetics of digoxin and atenolol in healthy subjects. Clin Pharmacol. 2017;9:19–28.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gelosa P, Castiglioni L, Tenconi M, Baldessin L, Racagni G, Corsini A, Bellosta S. Pharmacokinetic drug interactions of the non-vitamin K antagonist oral anticoagulants (NOACs). Pharmacol Res. 2018;135:60–79.

    Article  CAS  PubMed  Google Scholar 

  • Giuseppe B, Cecile L, Igor D, Elisa F, Ioachim PM, Hvilsted RL, Gianfranco S, Lucian P, Luigi T, Maggioni Aldo P, Lip Gregory YH. Asymptomatic atrial fibrillation: clinical correlates, management and outcomes in the EORP-AF Pilot General Registry. Am J Med. 2014;128(5):509–18.e2.

    Google Scholar 

  • Gnoth MJ, Buetehorn U, Muenster U, Schwarz T, Sandmann S. In vitro and in vivo P-glycoprotein transport characteristics of rivaroxaban. J Pharmacol Exp Ther. 2011;338(1):372–80.

    Article  CAS  PubMed  Google Scholar 

  • Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and risk factors in atrial fibrillation (ATRIA) study. JAMA. 2001;285(18):2370–5.

    Article  CAS  PubMed  Google Scholar 

  • Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER III, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, C. American Heart Association Statistics, and S. Stroke Statistics. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–e292.

    PubMed  Google Scholar 

  • Gosselin RC, Adcock DM, Bates SM, Douxfils J, Favaloro EJ, Gouin-Thibault I, Guillermo C, Kawai Y, Lindhoff-Last E, Kitchen S. International Council for Standardization in Haematology (ICSH) recommendations for laboratory measurement of direct oral anticoagulants. Thromb Haemost. 2018;118(3):437–50.

    Article  PubMed  Google Scholar 

  • Hartter S, Sennewald R, Nehmiz G, Reilly P. Oral bioavailability of dabigatran etexilate (Pradaxa((R)) ) after co-medication with verapamil in healthy subjects. Br J Clin Pharmacol. 2013a;75(4):1053–62.

    Article  PubMed  CAS  Google Scholar 

  • Hartter S, Sennewald R, Schepers C, Baumann S, Fritsch H, Friedman J. Pharmacokinetic and pharmacodynamic effects of comedication of clopidogrel and dabigatran etexilate in healthy male volunteers. Eur J Clin Pharmacol. 2013b;69(3):327–39.

    Article  PubMed  CAS  Google Scholar 

  • Hashikata T, Yamaoka-Tojo M, Namba S, Kitasato L, Kameda R, Murakami M, Niwano H, Shimohama T, Tojo T, Ako J. Rivaroxaban inhibits angiotensin II-induced activation in cultured mouse cardiac fibroblasts through the modulation of NF-kappaB pathway. Int Heart J. 2015;56(5):544–50.

    Article  CAS  PubMed  Google Scholar 

  • Holtzman CW, Wiggins BS, Spinler SA. Role of P-glycoprotein in statin drug interactions. Pharmacotherapy. 2006;26(11):1601–7.

    Article  CAS  PubMed  Google Scholar 

  • Kubitza D, Becka M, Mueck W, Zuehlsdorf M. Safety, tolerability, pharmacodynamics, and pharmacokinetics of rivaroxaban—an oral, direct factor Xa inhibitor—are not affected by aspirin. J Clin Pharmacol. 2006;46(9):981–90.

    Article  CAS  PubMed  Google Scholar 

  • Kubitza D, Becka M, Roth A, Mueck W. Absence of clinically relevant interactions between rivaroxaban—an oral, direct factor Xa inhibitor—and digoxin or atorvastatin in healthy subjects. J Int Med Res. 2012;40(5):1688–707.

    Article  CAS  PubMed  Google Scholar 

  • Kubitza D, Berkowitz SD, Misselwitz F. Evidence-based development and rationale for once-daily rivaroxaban dosing regimens across multiple indications. Clin Appl Thromb Hemost. 2016;22(5):412–22.

    Article  CAS  PubMed  Google Scholar 

  • Liesenfeld KH, Lehr T, Dansirikul C, Reilly PA, Connolly SJ, Ezekowitz MD, Yusuf S, Wallentin L, Haertter S, Staab A. Population pharmacokinetic analysis of the oral thrombin inhibitor dabigatran etexilate in patients with non-valvular atrial fibrillation from the RE-LY trial. J Thromb Haemost. 2011;9(11):2168–75.

    Article  CAS  PubMed  Google Scholar 

  • Lip GY, Laroche C, Ioachim PM, Rasmussen LH, Vitali-Serdoz L, Petrescu L, Darabantiu D, Crijns HJ, Kirchhof P, Vardas P, Tavazzi L, Maggioni AP, Boriani G. Prognosis and treatment of atrial fibrillation patients by European cardiologists: one year follow-up of the EURObservational research Programme-atrial fibrillation general registry pilot phase (EORP-AF pilot registry). Eur Heart J. 2014;35(47):3365–76.

    Article  CAS  PubMed  Google Scholar 

  • LIXIANA. 2018. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002629/WC500189045.pdf.

  • Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, D’Agostino RB, Massaro JM, Beiser A, Wolf PA, Benjamin EJ. Lifetime risk for development of atrial fibrillation: the Framingham heart study. Circulation. 2004;110(9):1042–6.

    Article  PubMed  Google Scholar 

  • Lopes RD, Heizer G, Aronson R, Vora AN, Massaro T, Mehran R, Goodman SG, Windecker S, Darius H, Li J, Averkov O, Bahit MC, Berwanger O, Budaj A, Hijazi Z, Parkhomenko A, Sinnaeve P, Storey RF, Thiele H, Vinereanu D, Granger CB, Alexander JH, Investigators A. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med. 2019;380(16):1509–24.

    Article  CAS  PubMed  Google Scholar 

  • Marsousi N, Doffey-Lazeyras F, Rudaz S, Desmeules JA, Daali Y. Intestinal permeability and P-glycoprotein-mediated efflux transport of ticagrelor in Caco-2 monolayer cells. Fundam Clin Pharmacol. 2016;30(6):577–84.

    Article  CAS  PubMed  Google Scholar 

  • Mathy FX, Dohin E, Bonfitto F, Pelgrims B. Drug-drug interaction between levetiracetam and non-vitamin K antagonist anticoagulants. Eur Heart J. 2019;40(19):1571.

    Article  CAS  PubMed  Google Scholar 

  • Matsushima N, Lee F, Sato T, Weiss D, Mendell J. Bioavailability and safety of the factor Xa inhibitor edoxaban and the effects of quinidine in healthy subjects. Clin Pharmacol Drug Dev. 2013;2(4):358–66.

    Article  CAS  PubMed  Google Scholar 

  • Medicines. [Internet], S.d.e., Pradaxa 150 mg hard capsules. Summary of Product Characteristics (SPC)d(eMC). 2015. http://www.medicines.org.uk/emc/medicine/24839, Last updated on eMC 30 Jan 2015. Accessed 18 May 2015.

  • Mendell J, Zahir H, Matsushima N, Noveck R, Lee F, Chen S, Zhang G, Shi M. Drug-drug interaction studies of cardiovascular drugs involving P-glycoprotein, an efflux transporter, on the pharmacokinetics of edoxaban, an oral factor Xa inhibitor. Am J Cardiovasc Drugs. 2013a;13(5):331–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mendell J, Lee F, Chen S, Worland V, Shi M, Samama MM. The effects of the antiplatelet agents, aspirin and naproxen, on pharmacokinetics and pharmacodynamics of the anticoagulant edoxaban, a direct factor Xa inhibitor. J Cardiovasc Pharmacol. 2013b;62(2):212–21.

    Article  CAS  PubMed  Google Scholar 

  • Mendell J, Chen S, He L, Desai M, Parasramupria DA. The effect of rifampin on the pharmacokinetics of edoxaban in healthy adults. Clin Drug Investig. 2015;35(7):447–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TS. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114(2):119–25.

    Article  PubMed  Google Scholar 

  • Mueck W, Kubitza D, Becka M. Co-administration of rivaroxaban with drugs that share its elimination pathways: pharmacokinetic effects in healthy subjects. Br J Clin Pharmacol. 2013;76(3):455–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nutescu EA, Shapiro NL, Ibrahim S, West P. Warfarin and its interactions with foods, herbs and other dietary supplements. Expert Opin Drug Saf. 2006;5(3):433–51.

    Article  CAS  PubMed  Google Scholar 

  • Oh J, Shin D, Lim KS, Lee S, Jung KH, Chu K, Hong KS, Shin KH, Cho JY, Yoon SH, Ji SC, Yu KS, Lee H, Jang IJ. Aspirin decreases systemic exposure to clopidogrel through modulation of P-glycoprotein but does not alter its antithrombotic activity. Clin Pharmacol Ther. 2014;95(6):608–16.

    Article  CAS  PubMed  Google Scholar 

  • Parasrampuria DA, Truitt KE. Pharmacokinetics and pharmacodynamics of edoxaban, a non-vitamin K antagonist oral anticoagulant that inhibits clotting factor Xa. Clin Pharmacokinet. 2016;55(6):641–55.

    Article  CAS  PubMed  Google Scholar 

  • Parasrampuria DA, Mendell J, Shi M, Matsushima N, Zahir H, Truitt K. Edoxaban drug-drug interactions with ketoconazole, erythromycin, and cyclosporine. Br J Clin Pharmacol. 2016;82(6):1591–600.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Perera KS, Ng KKH, Nayar S, Catanese L, Dyal L, Sharma M, Connolly SJ, Yusuf S, Bosch J, Eikelboom JW, Hart RG. Association between low-dose rivaroxaban with or without aspirin and ischemic stroke subtypes: a secondary analysis of the COMPASS trial. JAMA Neurol. 2020;77(1):43–8.

    Article  PubMed  Google Scholar 

  • Raskob GE, van Es N, Verhamme P, Carrier M, Di Nisio M, Garcia D, Grosso MA, Kakkar AK, Kovacs MJ, Mercuri MF, Meyer G, Segers A, Shi M, Wang TF, Yeo E, Zhang G, Zwicker JI, Weitz JI, Buller HR, V.T.E.C.I. Hokusai. Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med. 2018;378(7):615–24.

    Article  CAS  PubMed  Google Scholar 

  • Salazar DE, Mendell J, Kastrissios H, Green M, Carrothers TJ, Song S, Patel I, Bocanegra TS, Antman EM, Giugliano RP, Kunitada S, Dornseif B, Shi M, Tachibana M, Zhou S, Rohatagi S. Modelling and simulation of edoxaban exposure and response relationships in patients with atrial fibrillation. Thromb Haemost. 2012;107(5):925–36.

    Article  CAS  PubMed  Google Scholar 

  • Stangier J, Stahle H, Rathgen K, Roth W, Reseski K, Kornicke T. Pharmacokinetics and pharmacodynamics of dabigatran etexilate, an oral direct thrombin inhibitor, with coadministration of digoxin. J Clin Pharmacol. 2012;52(2):243–50.

    Article  CAS  PubMed  Google Scholar 

  • Steffel J, Giugliano RP, Braunwald E, Murphy SA, Atar D, Heidbuchel H, Camm AJ, Antman EM, Ruff CT. Edoxaban vs. warfarin in patients with atrial fibrillation on amiodarone: a subgroup analysis of the ENGAGE AF-TIMI 48 trial. Eur Heart J. 2015;36(33):2239–45.

    Article  CAS  PubMed  Google Scholar 

  • Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, Haeusler KG, Oldgren J, Reinecke H, Roldan-Schilling V, Rowell N, Sinnaeve P, Collins R, Camm AJ, Heidbuchel H, E.S.C.S.D. Group. The 2018 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J. 2018a;39(16):1330–93.

    Article  CAS  PubMed  Google Scholar 

  • Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, Georg Haeusler K, Oldgren J, Reinecke H, Roldan-Schilling V, Rowell N, Sinnaeve P, Collins R, Camm AJ, Heidbuchel H, E.S.C.S.D. Group. The 2018 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018b;20(8):1231–42.

    Article  PubMed  Google Scholar 

  • Teklay G, Shiferaw N, Legesse B, Bekele ML. Drug-drug interactions and risk of bleeding among inpatients on warfarin therapy: a prospective observational study. Thromb J. 2014;12:20.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Testa S, Tripodi A, Legnani C, Pengo V, Abbate R, Dellanoce C, Carraro P, Salomone L, Paniccia R, Paoletti O, Poli D, Palareti G, Register ST-L. Plasma levels of direct oral anticoagulants in real life patients with atrial fibrillation: results observed in four anticoagulation clinics. Thromb Res. 2016;137:178–83.

    Article  CAS  PubMed  Google Scholar 

  • US Food and Drug Administration. Guidance for industry. Drug interaction studies—design, data analysis, implications for dosing, and labeling instructions. 2018. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM292362.pdf. Accessed 6 Jun 2018.

  • Vavricka SR, Van Montfoort J, Ha HR, Meier PJ, Fattinger K. Interactions of rifamycin SV and rifampicin with organic anion uptake systems of human liver. Hepatology. 2002;36(1):164–72.

    Article  CAS  PubMed  Google Scholar 

  • Wessler JD, Grip LT, Mendell J, Giugliano RP. The P-glycoprotein transport system and cardiovascular drugs. J Am Coll Cardiol. 2013;61(25):2495–502.

    Article  CAS  PubMed  Google Scholar 

  • West TA, Perram J, Holloway CJ. Use of direct oral anticoagulants for treatment of atrial fibrillation in patients with HIV: a review. Curr Opin HIV AIDS. 2017;12(6):554–60.

    Article  CAS  PubMed  Google Scholar 

  • Xu H, Ruff CT, Giugliano RP, Murphy SA, Nordio F, Patel I, Shi M, Mercuri M, Antman EM, Braunwald E. Concomitant use of single antiplatelet therapy with edoxaban or warfarin in patients with atrial fibrillation: analysis from the ENGAGE AF-TIMI48 trial. J Am Heart Assoc. 2016;5(2):e002587.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yamazaki M, Li B, Louie SW, Pudvah NT, Stocco R, Wong W, Abramovitz M, Demartis A, Laufer R, Hochman JH, Prueksaritanont T, Lin JH. Effects of fibrates on human organic anion-transporting polypeptide 1B1-, multidrug resistance protein 2- and P-glycoprotein-mediated transport. Xenobiotica. 2005;35(7):737–53.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy

    Alberto Corsini

  2. Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy

    Nicola Ferri

Authors
  1. Alberto Corsini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicola Ferri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicola Ferri .

Editor information

Editors and Affiliations

  1. Cardiac Rehabilitation Unit Ospedale, Sacra Famiglia Fatebenefratelli, Erba, Italy

    Riccardo Proietti

  2. McGill University, Montreal, QC, Canada

    Ahmed AlTurki

  3. Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova, Italy

    Nicola Ferri

  4. Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli” - Monaldi Hospital, Naples, Italy

    Vincenzo Russo

  5. Division of Cardiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    T. Jared Bunch

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Corsini, A., Ferri, N. (2021). Drug–Drug Interaction with DOACs. In: Proietti, R., AlTurki, A., Ferri, N., Russo, V., Bunch, T.J. (eds) Direct Oral Anticoagulants. Springer, Cham. https://doi.org/10.1007/978-3-030-74462-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-74462-5_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-74461-8

  • Online ISBN: 978-3-030-74462-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation