Rifampicin and dabigatran etexilate: A place for laboratory coagulation monitoring

摘要

The paper by Hartter et?al. on the interaction between dabigatran etexilate and rifampicin [1] is an important addition to the published data on drug–drug interactions involving dabigatran etexilate. Dabigatran etexilate is a substrate of intestinal P-glycoprotein (P-gp). Compared with dabigatran etexilate alone, the co-administration of rifampicin, a P-gp inducer, was associated with a 67% reduction in dabigatran AUC(0,∞). Consequently, Hartter et?al. recommend that this drug–drug interaction be managed by avoiding the combination of dabigatran etexilate and rifampicin or any other P-gp inducers, e.g. carbamazepine. We would like to suggest an alternative management strategy to avoidance of such drug combinations.