Tag: dvt/pe

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Conjugated Estrogens Pharmacology

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Conjugated estrogens (Premarin) are most often used in the management of menopausal symptoms.

Estrogen therapy can increase the risk for breast cancer and the risk should be assessed before beginning therapy.

Blood clots are a potential consequence from the use of Premarin. Premarin can oppose the benefit of anticoagulation.

Conjugated estrogens are broken down by CYP3A4. Inhibitors may increase concentrations while inducers may reduce concentrations.

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Rivaroxaban Pharmacology

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Rivaroxaban is a factor 10a inhibitor that inhibits clot formation and thins the blood.

Rivaroxaban needs to be monitored for bleed risk. Checking periodic CBC can help us assess if hemoglobin and hematocrit are remaining stable.

Enzyme inducers like rifampin, St. John’s Wort, and carbamazepine can reduce concentrations and increase the risk of treatment failure.

NSAIDs and antiplatelet medications can significantly increase the risk of bleed with rivaroxaban.

Rivaroxaban should not be used with dual P-glycoprotein and CYP3A4 inhibitors. Examples include ketoconazole, itraconazole, and ritonavir.

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