Key result
Reducing the daily rivaroxaban dose to 10-15 mg during concomitant verapamil administration reduces major bleeding risk below a 4.5% threshold in most patients with normal or mildly impaired renal function.
Why the study?
Does coadministration of verapamil increase rivaroxaban exposure and bleeding risk in healthy and renally impaired subjects?
Population
Healthy and renally impaired subjects (simulated cohort based on phase 1 drug-drug interaction study data)
Comparison
Coadministration of rivaroxaban and verapamil vs Rivaroxaban without verapamil
Design
Other
Authors
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May inform verapamil-related dose adjustments; leaves open prospective validation before practice change.
Does coadministration of verapamil increase rivaroxaban exposure and bleeding risk in healthy and renally impaired subjects?
Pharmacokinetic modeling suggests that patients taking both rivaroxaban and verapamil require a reduced daily dose of rivaroxaban (10-15 mg) to minimize major bleeding risk, especially in those with renal impairment.
Ismail et al. (2017) studied Healthy and renally impaired subjects. Rivaroxaban and verapamil coadministration was evaluated on Major bleeding risk. Reducing the daily rivaroxaban dose to 10-15 mg during concomitant verapamil administration reduces major bleeding risk below a 4.5% threshold in most patients with normal or mildly impaired renal function.
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