<?xml version="1.0" encoding="UTF-8"?><MedicinalProductInteraction xmlns="http://hl7.org/fhir"><id value="936a22b3-5ea8-4f97-9105-300c41e8776b"/><meta><versionId value="1"/><lastUpdated value="2022-02-17T17:34:54.876+08:00"/><tag><system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/><code value="HTEST"/><display value="test health data"/></tag></meta><description value="Inhibitors of CYP3A4 and P-gp\nCoadministration of equixaban with ketoconazole (400 mg once a day), a strong inhibitor of both\nCYP3A4 and P-gp, led to a 2-fold increase in mean equixaban AUC and a 1.6-fold increase in mean\nequixaban Cmax.\nThe use of Eliquis is not recommended in patients receiving concomitant systemic treatment with\nstrong inhibitors of both CYP3A4 and P-gp, such as azole-antimycotics (e.g., ketoconazole,\nitraconazole, voriconazole and posaconazole) and HIV protease inhibitors (e.g., ritonavir) (see\nsection 4.4).\nActive substances which are not considered strong inhibitors of both CYP3A4 and P-gp,\n(e.g., diltiazem, naproxen, amiodarone, verapamil, quinidine) are expected to increase equixaban\nplasma concentration to a lesser extent. Diltiazem (360 mg once a day), for instance, considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1.4-fold increase in mean equixaban AUC and a 1.3-fold increase in Cmax. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1.5-fold and 1.6-fold increase in mean equixaban AUC and Cmax, respectively. No dose adjustment for equixaban is required when coadministered with less potent inhibitors of CYP3A4 and/or P-gp."/><interactant><itemCodeableConcept><coding><system value="http://ema.europa.eu/example/interactant"/><code value="ketoconazole"/></coding></itemCodeableConcept></interactant><interactant><itemCodeableConcept><coding><system value="http://ema.europa.eu/example/interactant"/><code value="itraconazole"/></coding></itemCodeableConcept></interactant><type><coding><system value="http://ema.europa.eu/example/interactionsType"/><code value="StrongInhibitorofCYP3A4"/></coding></type><effect><coding><system value="http://ema.europa.eu/example/interactionseffect"/><code value="Increasedplasmaconcentrations"/></coding></effect><management><text value="Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp"/></management></MedicinalProductInteraction>