Key result
Co-prescription of P-gp antagonists with dabigatran in elderly patients did not significantly increase the bleeding rate (23% vs 18%, p=0.64) despite resulting in higher dabigatran plasma concentrations.
Why the study?
Does co-prescription of P-gp antagonists with dabigatran increase bleeding occurrence in elderly patients?
Observational (n=119)
No
Does co-prescription of P-gp antagonists with dabigatran increase bleeding occurrence in elderly patients?
Co-prescription of P-gp antagonists with dabigatran modifies its pharmacokinetics but does not appear to increase bleeding risk in elderly patients in real-world settings.
Answers are grounded in this paper and cite their sources.
May support co-prescription of P-gp antagonists with dabigatran in elderly; leaves open confirmation in larger prospective studies.
The direct oral anticoagulant dabigatran (D) requires no routine therapeutic monitoring. Yet, drug interactions may increase its inherent bleeding risk, especially in the elderly. We aimed to evaluate to what extent co-prescription of P-gp antagonists with D may increase its plasma levels and lead to bleedings in usual conditions of care.
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Drici et al. (2018) conducted an observational in Patients receiving dabigatran (n=119). P-gp antagonists vs. No P-gp antagonist co-prescription was evaluated on Bleeding rate (p=0.64). Co-prescription of P-gp antagonists with dabigatran in elderly patients did not significantly increase the bleeding rate (23% vs 18%, p=0.64) despite resulting in higher dabigatran plasma concentrations.
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