Clinically relevant interaction of rivaroxaban and valproic acid – a case report

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During the past years, the use of non-vitamin K oral anticoagulants (NOAC) has become more and more widespread. One of the major advantages compared to vitamin K-antagonists is the easy administration without frequent therapeutic drug monitoring. Nevertheless, interactions with other substances must be kept in mind, as NOAC efficacy may change upon co-administration of inducers or inhibitors of cytochrome P450 3A4 (CYP3A4) or P-glycoprotein (P-gp). With epilepsy being a frequent comorbidity, especially in the setting of post-ischemic epilepsy, the number of patients who require oral anticoagulation as well as antiseizure drugs has been reported as high as 15.3% [1].

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