NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is a key drug-drug interaction concern for Factor Xa inhibitors like Apixaban and Rivaroxaban?

  1. Aspirin

  2. Vitamin K Antagonists

  3. Strong dual inducers of CYP3A4 and PGP

  4. NSAIDs

The correct answer is: Strong dual inducers of CYP3A4 and PGP

Factor Xa inhibitors like Apixaban and Rivaroxaban may interact with medications that are strong dual inducers of CYP3A4 and PGP. Dual inducers of CYP3A4 and PGP can decrease the effectiveness of Factor Xa inhibitors, which can potentially lead to blood clots and increase the risk of bleeding. Aspirin and NSAIDs are not known to have a significant interaction with Factor Xa inhibitors, although they may increase the risk of bleeding when used together. Vitamin K antagonists, on the other hand, have a different mechanism of action compared to Factor Xa inhibitors and do not have a direct drug-drug interaction. However, they both have an anticoagulant effect and may increase the risk of bleeding when used in combination. Therefore, the most important drug-drug interaction concern for Factor Xa inhibitors is with strong dual inducers of CYP3A4 and PGP, as they can affect the effectiveness of the medication.

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