TY -的A2 Arellano-Rodrigo爱德华多盟——一步安娜f . AU - Amuchastegui托马斯AU -塔巴,奥尔多·h . PY - 2017 DA - 2017/08/10 TI - Rivaroxaban水平降低脑静脉血栓形成患者接受苯妥英SP - 4760612六世- 2017 AB -联合使用抗癫痫药物和抗凝血剂是常见的。我们描述了第一例记录实验室rivaroxaban和苯妥英之间的互动。一个48岁的女子被我们医院由于脑静脉血栓形成,双边肺栓塞和深静脉血栓形成。她来自一个小镇与华法林监控困难的访问。她接受苯妥英每日三次,每次100毫克(t.i.d),开始伊诺肝素60毫克每天两次(b.i.d)。腹部肿块是诊断和被腹腔镜(胃肠道间质肿瘤)。5天,她转向rivaroxaban 15毫克b.i.d。第一个峰值anti-Factor Xa 70 ng / ml(参考价值:100 - 300 ng / ml)。她出院rivaroxaban 15毫克b.i.d.和苯妥英100毫克t.i.d。一个星期后,anti-Xa水平90 ng / ml。由于血栓进展的担忧,她转向dabigatran。在随访期间,她仍无症状,凝血酶时间> 180年代测量几次3个月作为dabigatran代理活动。 Phenytoin is a combined CYP3A4 and P-glycoprotein inducer, which might reduce rivaroxaban levels. Dabigatran is substrate of P-glycoprotein, meaning potential malabsorption. Despite unavailability of plasmatic dabigatran essays, our patient improved her symptoms without further symptomatic thromboembolism. Facing these interactions, either monitoring serum levels of anticoagulants or other therapeutic options should be considered. SN - 2090-6560 UR - https://doi.org/10.1155/2017/4760612 DO - 10.1155/2017/4760612 JF - Case Reports in Hematology PB - Hindawi KW - ER -