Eliquis and Omeprazole, Clarithromycin, and Amoxicillin

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer information for this interaction is not currently available.MONITOR: Coadministration with clarithromycin, a combined P-glycoprotein (P-gp) and strong CYP450 3A4 inhibitor, may increase the plasma concentrations of apixaban, which is a substrate of the efflux transporter as well as the isoenzyme. According to the manufacturer, clarithromycin (500 mg twice a day) led to 1.6- and 1.3-fold increases in apixaban AUC and Cmax, respectively. The clinical significance of these changes has not been established. In a retrospective cohort study that used data from the Taiwan National Health Insurance database and included 91,330 patients with nonvalvular atrial fibrillation who received at least 1 non-vitamin K oral anticoagulant (NOAC) prescription for apixaban, dabigatran, or rivaroxaban, the adjusted incidence rate for major bleeding was approximately 40% lower for concurrent use of clarithromycin or erythromycin compared to NOAC use alone. MANAGEMENT: No dosage adjustment for apixaban is recommended during coadministration with clarithromycin. However, caution is advised and pharmacologic effects of apixaban should be monitored more closely whenever clarithromycin is added to or withdrawn from therapy. Patients should be routinely evaluated for signs and symptoms suggesting blood loss such as a decrease in hemoglobin and/or hematocrit, hypotension, or fetal distress (in pregnant women). References Chang SH, Chou IJ, Yeh YH, et. al "Association between use of non–vitamin K oral anticoagulants with and without concurrent medications and risk of major bleeding in nonvalvular atrial fibrillation." JAMA 318 (2017): 1250-9 Cerner Multum, Inc. "Australian Product Information." O 0 Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb Canada Inc, Montreal, IN. Cerner Multum, Inc. "Canadian Product Information." O 0 (2015): "Product Information. Biaxin (clarithromycin)." Abbott Pharmaceutical, Abbott Park, IL. View all 6 references

MONITOR: Coadministration with clarithromycin, a combined P-glycoprotein (P-gp) and strong CYP450 3A4 inhibitor, may increase the plasma concentrations of apixaban, which is a substrate of the efflux transporter as well as the isoenzyme. According to the manufacturer, clarithromycin (500 mg twice a day) led to 1.6- and 1.3-fold increases in apixaban AUC and Cmax, respectively. The clinical significance of these changes has not been established. In a retrospective cohort study that used data from the Taiwan National Health Insurance database and included 91,330 patients with nonvalvular atrial fibrillation who received at least 1 non-vitamin K oral anticoagulant (NOAC) prescription for apixaban, dabigatran, or rivaroxaban, the adjusted incidence rate for major bleeding was approximately 40% lower for concurrent use of clarithromycin or erythromycin compared to NOAC use alone.

MANAGEMENT: No dosage adjustment for apixaban is recommended during coadministration with clarithromycin. However, caution is advised and pharmacologic effects of apixaban should be monitored more closely whenever clarithromycin is added to or withdrawn from therapy. Patients should be routinely evaluated for signs and symptoms suggesting blood loss such as a decrease in hemoglobin and/or hematocrit, hypotension, or fetal distress (in pregnant women).

Eliquis

Generic Name: apixaban

Brand name: Eliquis, Eliquis Starter Pack for Treatment of DVT and PE

Synonyms: n.a.

What is Eliquis?

Omeprazole, Clarithromycin, and Amoxicillin

Generic Name: amoxicillin / clarithromycin / omeprazole

Brand name: Omeclamox-Pak

Synonyms: Amoxicillin, clarithromycin, and omeprazole

What is Omeprazole, Clarithromycin, and Amoxicillin?