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Table 2 Drug-drug and food-drug interactions of DOACs. Adapted from references [20,21,22,23]

From: Antiphospholipid Syndrome Committee of the Brazilian Society of Rheumatology position statement on the use of direct oral anticoagulants (DOACs) in antiphospholipid syndrome (APS)

Pharmacokinetic interaction Pharmacodynamic interaction
Can decrease DOAC concentration Can increase DOAC concentration Can increase risk of bleeding
Carbamazepine Amiodarone Aspirin
Phenobarbital Clarithromycin ADP receptor (P2Y12) inhibitors (clopidogrel, prasugrel, ticarelor)
Phenytoin Cyclosporin A Fibrinolytics (alteplase, tenecteplase)
Rifampin Diltiazem Heparins
St John’s Wort Dronedarone NSAIDs
  Grapefruit components (p.e. furanocoumarins) SNRIs/SSRIs
  Itraconazole Warfarin
  Ketoconazole  
  Nelfinavir  
  Quinidine  
  Ritonavir  
  Tacrolimus  
  Verapamil  
  1. DOAC Direct oral anticoagulants, NSAIDs non-steroidal anti-inflammatory drugs, SNRIs serotonin norepinephrine reuptake inhibitors, SSRIs selective serotonin reuptake inhibitors