Case report: Drug-drug interaction between alectinib and apixaban in NSCLC
Plasma concentrations of direct oral anticoagulants (DOAC) are potentially affected because of drug-drug interactions (DDI) with anticancer treatment as a result of inhibition or induction of CYP3A4, p-glycoprotein (P-gp) and/or Breast Cancer Resistance Protein (BCRP) interactions.Here, we present a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Current Problems in Cancer: Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666621922000503 |
| _version_ | 1811272121783943168 |
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| author | J.L. Gulikers M. Slikkerveer K. Winckers L.E.L. Hendriks S. Dursun S. Croes R.M.J.M. van Geel |
| author_facet | J.L. Gulikers M. Slikkerveer K. Winckers L.E.L. Hendriks S. Dursun S. Croes R.M.J.M. van Geel |
| author_sort | J.L. Gulikers |
| collection | DOAJ |
| description | Plasma concentrations of direct oral anticoagulants (DOAC) are potentially affected because of drug-drug interactions (DDI) with anticancer treatment as a result of inhibition or induction of CYP3A4, p-glycoprotein (P-gp) and/or Breast Cancer Resistance Protein (BCRP) interactions.Here, we present a 78-year-old patient with non-small cell lung cancer (NSCLC) receiving treatment with alectinib concurrent with apixaban as prophylactic treatment of recurrent thrombophlebitis. Given the unexpected high apixaban plasma concentrations, the apixaban dose was reduced stepwise to 25% of its original dose in order to achieve values within the on-therapy reference range. This case demonstrates that monitoring DOAC plasma concentrations may be indicated when DOACs are used concurrently with alectinib. |
| first_indexed | 2024-04-12T22:34:34Z |
| format | Article |
| id | doaj.art-0d89b289fb7547b4907d0096501bd973 |
| institution | Directory Open Access Journal |
| issn | 2666-6219 |
| language | English |
| last_indexed | 2024-04-12T22:34:34Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Current Problems in Cancer: Case Reports |
| spelling | doaj.art-0d89b289fb7547b4907d0096501bd9732022-12-22T03:13:53ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192022-09-017100186Case report: Drug-drug interaction between alectinib and apixaban in NSCLCJ.L. Gulikers0M. Slikkerveer1K. Winckers2L.E.L. Hendriks3S. Dursun4S. Croes5R.M.J.M. van Geel6Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, the NetherlandsDepartment of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the NetherlandsCARIM School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, the NetherlandsDepartment of Pulmonary Diseases, GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the NetherlandsDepartment of Pulmonary Diseases, GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the NetherlandsDepartment of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, the NetherlandsDepartment of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands; CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands; Corresponding author at: Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands.Plasma concentrations of direct oral anticoagulants (DOAC) are potentially affected because of drug-drug interactions (DDI) with anticancer treatment as a result of inhibition or induction of CYP3A4, p-glycoprotein (P-gp) and/or Breast Cancer Resistance Protein (BCRP) interactions.Here, we present a 78-year-old patient with non-small cell lung cancer (NSCLC) receiving treatment with alectinib concurrent with apixaban as prophylactic treatment of recurrent thrombophlebitis. Given the unexpected high apixaban plasma concentrations, the apixaban dose was reduced stepwise to 25% of its original dose in order to achieve values within the on-therapy reference range. This case demonstrates that monitoring DOAC plasma concentrations may be indicated when DOACs are used concurrently with alectinib.http://www.sciencedirect.com/science/article/pii/S2666621922000503ApixabanAlectinibDOACDDI |
| spellingShingle | J.L. Gulikers M. Slikkerveer K. Winckers L.E.L. Hendriks S. Dursun S. Croes R.M.J.M. van Geel Case report: Drug-drug interaction between alectinib and apixaban in NSCLC Current Problems in Cancer: Case Reports Apixaban Alectinib DOAC DDI |
| title | Case report: Drug-drug interaction between alectinib and apixaban in NSCLC |
| title_full | Case report: Drug-drug interaction between alectinib and apixaban in NSCLC |
| title_fullStr | Case report: Drug-drug interaction between alectinib and apixaban in NSCLC |
| title_full_unstemmed | Case report: Drug-drug interaction between alectinib and apixaban in NSCLC |
| title_short | Case report: Drug-drug interaction between alectinib and apixaban in NSCLC |
| title_sort | case report drug drug interaction between alectinib and apixaban in nsclc |
| topic | Apixaban Alectinib DOAC DDI |
| url | http://www.sciencedirect.com/science/article/pii/S2666621922000503 |
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