决奈达隆和直接口服抗凝血药相互作用的研究进展  

Updates on drug-drug interactions between dronedarone and direct oral anticoagulants

作　　者：姚云娟 张峻[1] 吴迪[1] YAO Yun-juan;ZHANG Jun;WU Di(Department of Clinical Pharmacy,The First Affiliated Hospital of Kunming Medical University,Kunming 650032)

机构地区：[1]昆明医科大学第一附属医院临床药学科,昆明650032

出　　处：《中南药学》2023年第3期731-735,共5页Central South Pharmacy

基　　金：昆明医科大学研究生创新基金(No.2022S249)。

摘　　要：房颤患者在接受抗凝治疗的同时,常需要联合抗心律失常药。在抗凝血药与抗心律失常药联用方案中,直接口服抗凝血药联合决奈达隆较为常见。直接口服抗凝血药均为P-糖蛋白(P-gp)的底物,且部分经细胞色素P450(CYP450)酶代谢;而决奈达隆能抑制P-gp的转运,是CYP3A4的中度抑制剂,两者联用可能会发生相互作用,从而影响房颤患者的抗凝治疗安全性。由于相关研究数量有限,目前国内外指南及专家共识对决奈达隆与直接口服抗凝血药联用的推荐存在不一致现象,本文对决奈达隆分别与四种直接口服抗凝血药相互作用的最新研究进行综述,以期为临床合理用药提供更多参考依据。Patients with atrial fibrillation often receive a concomitant administration of antiarrhythmic drugs and anticoagulations,most commonly dronedarone with direct oral anticoagulants(DOACs).Dronedarone is a moderate inhibitor of CYP3A4 and P-glycoproteins(P-gp),while all DOACs are substrates of P-gp and are partly metabolized by CYP450 enzymes.There have been safety concerns of dronedarone when used in combination with DOACs,yet current recommendations have conflicts due to limited clinical evidence.This article reviewed recent studies on interaction between dronedarone with 4 DOACs to provide more references for rational clinical use.

关 键 词：直接口服抗凝血药 决奈达隆 房颤 药物相互作用 

分 类 号：R96[医药卫生—药理学]