with atrial fibrillation or atrial flutter and coronary artery disease is shown in - Summary of Recommendations for Antithrombotic Management in Patients with Coronary Artery Disease . Table 8: Drug Therapy for Prevention of Systemic Embolism in Patients with Supraventricular Tachycardia Class Drug Dose Adverse Effects Drug Interactions Direct Factor Xa Usual: 5 mg BID po Bleeding. Contraindicated in combination $ apixaban Inhibitors If serum creatinine >133 with strong inhibitors of both mmoL/L and patient CYP3A4 and P-gp (e.g., either >80 y or kg: itraconazole, ritonavir). ≤60 2.5 mg BID po Direct Factor Xa 20 mg daily po Bleeding. Contraindicated in combination rivaroxaban Inhibitors Moderate renal with strong inhibitors of both impairment (ClCr 30–49 CYP3A4 and P-gp (e.g., mL/min): 15 mg daily po itraconazole, ritonavir). Direct Thrombin 150 mg BID po Bleeding, gastric Contraindicated in combination $ dabigatran Inhibitors Patients with increased intolerance. with strong inhibitors of P-gp (e.g., bleeding risk or >80 y: ketoconazole). Caution with other 110 mg BID po drugs acting on P-gp. Vitamin K Dose to maintain INR Bleeding, skin necrosis. Many potential interactions. warfarin Antagonists , generics between 2 and 3 Contraindicated in Substrate for CYP2C9 and other pregnancy. isoenzymes. Legend: <$10 $$ $10–50 $$$ $50–90 $$$$ $90–130 Cardiovascular Disorders: Supraventricular Tachycardia; David Birnie, MD and Pablo Nery, MD; Date of revision: May 2014
with atrial fibrillation or atrial flutter and coronary artery disease is shown in - Summary of Recommendations for Antithrombotic Management in Patients with Coronary Artery Disease . Table 8: Drug Therapy for Prevention of Systemic Embolism in Patients with Supraventricular Tachycardia Class Drug Dose Adverse Effects Drug Interactions Direct Factor Xa Inhibitors apixaban Usual: 5 mg BID po If serum creatinine >133 mmoL/L and patient either >80 y or ≤60 kg: 2.5 mg BID po Bleeding. Contraindicated in combination with strong inhibitors of both CYP3A4 and P-gp (e.g., itraconazole, ritonavir). Direct Factor Xa Inhibitors rivaroxaban 20 mg daily po Moderate renal impairment (ClCr 30–49 mL/min): 15 mg daily po Bleeding. Contraindicated in combination with strong inhibitors of both CYP3A4 and P-gp (e.g., itraconazole, ritonavir). Direct Thrombin Inhibitors dabigatran 150 mg BID po Patients with increased bleeding risk or >80 y: 110 mg BID po Bleeding, gastric intolerance. Contraindicated in combination with strong inhibitors of P-gp (e.g., ketoconazole). Caution with other drugs acting on P-gp. Vitamin K Antagonists warfarin , generics Dose to maintain INR between 2 and 3 Bleeding, skin necrosis. Contraindicated in pregnancy. Many potential interactions. Substrate for CYP2C9 and other isoenzymes. $ Legend: $ <$10 $$ $10–50 $$$ $50–90 $$$$ $90–130 Cardiovascular Disorders: Supraventricular Tachycardia; David Birnie, MD and Pablo Nery, MD; Date of revision: May 2014
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