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PLoS ONE

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Does amiodarone impact on apixaban levels? The effect of amiodarone on apixaban level among Thai patients with non-valvular Atrial Fibrillation.

Published:19 January 2024 DOI: 10.1371/journal.pone.0295511 PMID: 38241292
Sutee Limcharoen,?Sarawuth Limprasert,?Pornwalai Boonmuang,?Manat Pongchaidecha,?Juthathip Suphanklang,?Weerayuth Saelim,?Wichai Santimaleeworagun,?Piyarat Pimsi

Abstract

Background: Apixaban and amiodarone are drugs used for non-valvular atrial fibrillation (NVAF) in routine practice. The evidence about apixaban plasma levels in patients who receive apixaban with amiodarone, including bleeding outcomes, has been limited. This study aimed to compare the apixaban plasma levels and bleeding outcomes between apixaban monotherapy and apixaban with amiodarone groups.

Methods: This study was a prospective, observational, and single-center research which was conducted from January 2021 to January 2022 in NVAF patients who received apixaban at a tertiary care hospital located in the center of Bangkok, Thailand.

Results: Thirty-three patients were measured for their median (5th-95th percentile) apixaban plasma levels. The trough of apixaban plasma level (Ctrough) were 108.49 [78.10-171.52] and 162.05 [87.94-292.88] μg/L in the apixaban monotherapy and apixaban with amiodarone groups, respectively (p = 0.028). Additionally, the peaks of apixaban plasma level (Cpeak) were 175.36 [122.94-332.34] and 191 [116.88-488.21] μg/L in the apixaban monotherapy and apixaban with amiodarone groups, respectively (p = 0.375). There was bleeding that occurred in 7 patients (21.21%); 5 patients in the apixaban monotherapy group and 2 patients in the apixaban with amiodarone group, respectively.

Conclusions: Amiodarone may increase the peaks and troughs of apixaban plasma levels. The co-administration of apixaban with amiodarone is generally well tolerated. However, the careful observation of bleeding symptoms in individual cases is necessary to ensure safety.

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Related products
Procduct Name CAS Molecular Formula Supplier Price
Apixaban 503612-47-3 C25H25N5O4 822 suppliers $5.00-$3036.00
Amiodarone 1951-25-3 C25H29I2NO3 152 suppliers Inquiry

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