<?xml version="1.0" encoding="UTF-8"?><MedicinalProductInteraction xmlns="http://hl7.org/fhir"><id value="example"/><meta><tag><system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/><code value="HTEST"/><display value="T03Ke3vZhQ"/></tag></meta><text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>description</b>: 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.</p><blockquote><p><b>interactant</b></p><p><b>item</b>: ketoconazole <span>(Details : {http://ema.europa.eu/example/interactant code 'ketoconazole' = 'ketoconazole)</span></p></blockquote><blockquote><p><b>interactant</b></p><p><b>item</b>: itraconazole <span>(Details : {http://ema.europa.eu/example/interactant code 'itraconazole' = 'itraconazole)</span></p></blockquote><p><b>type</b>: StrongInhibitorofCYP3A4 <span>(Details : {http://ema.europa.eu/example/interactionsType code 'StrongInhibitorofCYP3A4' = 'StrongInhibitorofCYP3A4)</span></p><p><b>effect</b>: Increasedplasmaconcentrations <span>(Details : {http://ema.europa.eu/example/interactionseffect code 'Increasedplasmaconcentrations' = 'Increasedplasmaconcentrations)</span></p><p><b>management</b>: Coadministration not recommended in patients receiving concomitant systemic treatment strong inhibitors of both CYP3A4 and P-gp <span>(Details )</span></p></div></text><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="Fa3DHffh0FEh4SC07X"/></management></MedicinalProductInteraction>