Effect of amiodarone on rivaroxaban plasma concentration in patients with non-valvular atrial fibrillation
10.3760/cma.j.cn114015-20200309-00241
- VernacularTitle:胺碘酮对非瓣膜病心房颤动患者利伐沙班血药浓度的影响
- Author:
Yatong ZHANG
1
;
Junpeng LIU
;
Zinan ZHAO
;
Hongliu LU
;
Xin HU
Author Information
1. 北京医院药学部/国家老年医学中心 100730；中国医学科学院老年医学研究院，北京 100730
- Publication Type:Journal Article
- Keywords:
Rivaroxaban;
Amiodarone;
Atrial fibrillation;
Drug interactions;
Drug monitoring
- From:
Adverse Drug Reactions Journal
2020;22(8):450-454
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of amiodarone combined with rivaroxaban on the plasma concentration of rivaroxaban in patients with non-valvular atrial fibrillation.Methods:This study was designed as the prospective cohort study. The subjects were selected from patients with atrial fibrillation who were hospitalized in the Department of Cardiology of Beijing Hospital from January to October 2019 and treated with rivaroxaban (≥3 days). The enrolled patients were divided into the with amiodarone combination group and the without amiodarone combination group. The trough concentration and peak concentration of rivaroxaban were detected by chromogenic substrate method with anti-Xa assay kit. Taking the plasma concentration of patients with a daily dose of 20 mg of rivaroxaban as the standard, plasma concentrations in patients with various daily doses of rivaroxaban were standardized. The measured plasma concentrations, standardized plasma concentrations, and plasma concentrations in patients at daily dose of 20 mg of rivaroxaban were respectively compared between the 2 groups.Results:A total of 65 patients were entered in the study, including 12 patients in the with amiodarone combination group (the daily dose of rivaroxaban was 20 mg) and 53 patients in the without amiodarone combination group (the daily doses of rivaroxaban were 20, 15, and 10 mg in 42, 9, and 2 patients, respectively). The differences in gender, age, weight, body mass index, smoking history, CHA 2DS 2-VASc score, HAS-BLED score, daily dose of rivaroxaban, liver and kidney function, and platelet count of patients between the 2 groups were not statistically significant ( P>0.05 for all). The trough and peak plasma concentrations of rivaroxaban in the with amiodarone combination group were higher than those in the without combination amiodarone group, but the differences were not statistically significant [(43±30) ng/ml vs. (38±26) ng/ml, t=0.569, P=0.571; (294±114) ng/ml vs. (251±87) ng/ml, t=1.473, P=0.146]. The differences in standardized trough and peak plasma concentrations of rivaroxaban [(41±28) ng/ml, (273±108) ng/ml]in patients between the 2 groups, and the trough and peak plasma concentration [(40±27) ng/ml,(249±75) ng/ml]of patients at daily dose of 20 mg of rivaroxaban were not statistically significant ( P>0.05 for all). Conclusion:Amiodarone has no significant effects on the plasma concentration of rivaroxaban in patients with atrial fibrillation, however, it is still necessary to strengthen the patient monitoring in those with combination use of the 2 drugs.
