Safety of Concurrent Use of Escitalopram and Apixaban

Pharmacokinetics and Drug Interactions

• Apixaban is metabolized mainly by CYP3A4 and is a substrate for P-glycoprotein, which is important when considering concurrent use with other medications 1

Safety and Efficacy

• The American College of Cardiology notes that apixaban's metabolism by CYP3A4 is a key consideration in drug interactions, and monitoring of renal and hepatic function is recommended when prescribing apixaban with other medications 1
• The National Comprehensive Cancer Network guidelines recommend using apixaban with caution in patients with compromised renal or liver function 2
• The National Comprehensive Cancer Network guidelines also note that DOACs like apixaban should be used with caution in patients with increased bleeding risk 3

Renal and Hepatic Impairment

• Apixaban is contraindicated in patients with severe renal impairment (CrCl <30 mL/min) and should be used with caution in those with moderate renal or hepatic impairment 2, 3

Clinical Monitoring

• Regular monitoring of renal function is advisable as changes could affect apixaban clearance, according to clinical guidelines 4