Co-administration of rivaroxaban and enoxaparin increased anti-factor Xa activity by ~50% compared with either drug alone, without affecting the pharmacokinetics of rivaroxaban.
RCT
No
Does co-administration of rivaroxaban and enoxaparin alter pharmacodynamic and pharmacokinetic parameters compared to either drug alone in healthy male subjects?
Co-administration of rivaroxaban and enoxaparin enhances anti-factor Xa activity by ~50% without altering the pharmacokinetics of rivaroxaban.
Rivaroxaban, an oral, direct factor Xa inhibitor, is currently used in clinical practice for the prevention and treatment of thromboembolic disorders. This single-center, three-way crossover study was designed to investigate the pharmacodynamic effects of rivaroxaban (10 mg) and enoxaparin (40 mg) alone and in combination as well as the influence of enoxaparin on the pharmacokinetics of rivaroxaban in healthy male subjects. When given alone, both drugs exhibited similar, rapid anti-factor Xa activity. Combined administration resulted in an increase of ∼50% in anti-factor Xa activity and a lesser increase in activated partial thromboplastin time, compared with either drug alone. Enoxaparin had no additional effect on prolongation of the prothrombin time induced by rivaroxaban and did not affect the pharmacokinetic parameters of rivaroxaban. The results showed that rivaroxaban (10 mg) and enoxaparin (40 mg) had a similar and rapid onset of action, as indicated by the similar anti-factor Xa activity-time curves, suggesting that both drugs have a similar duration of pharmacological activity at the factor X site. Co-administration of rivaroxaban and enoxaparin is associated with enhanced pharmacodynamic effects.
Kubitza et al. (Wed,) conducted a rct in Healthy. Rivaroxaban and enoxaparin combination vs. Rivaroxaban 10 mg alone and enoxaparin 40 mg alone was evaluated on Anti-factor Xa activity. Co-administration of rivaroxaban and enoxaparin increased anti-factor Xa activity by ~50% compared with either drug alone, without affecting the pharmacokinetics of rivaroxaban.