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What Are The Interactions Between Dexamethasone And Xarelto?
Information about me and my situation: 40 yr female, 48kg. I have breast cancer, diagnosed in 2012, with metastases to liver and bones diagnosed later that same year. My current treatment, since May 2014, has been chemotherapy (CISplatin & Gemcitabine: cycle of two weeks on, one week off) At each treatment session of chemo I am given three 4mg Dexamethasone tablets followed by 2 tablets daily (morning & evening) for 2 days post chemo. I am responding very well to treatment at this time. A jugular blood clot was found in April this year, likely due to my port-a-cath, and was successfully treated with three months of Fragmin daily injections. For maintenance, I am now taking Xarelto 10mg daily. I see dexamethasone listed as a drug with possible interactions with Xarelto. What are your thoughts or concerns given my situation?
Wed, 15 Jul 2020
Hi,
Brief answer: There may be minor drug-drug interaction between Dexamethasone and Rivaroxaban (Xarelto), wherein the Dexamethasone may decrease the efficacy of Xarelto.
Detailed answer: Many drugs are metabolized (i.e., broken down) in the liver by a system of enzymes known as Cytochrome P450 (CYP450). Some drugs that are metabolized by this system can inhibit the metabolism of other drugs by this systems, while other drugs can enhance the metabolism of drugs by this system. Dexamethasone and Rivaroxaban (Xarelto) are both metabolized by the same CYP450 enzyme in the liver. Dexamethasone has been shown to increase the action of this enzyme so that the metabolism of other drugs is enhanced.
There is a possibility that Dexamethasone can increase the metabolism of Xarelto, thereby reducing the body's exposure to the drug and the its anticoagulant effect. Without the anti-coagulation effect of Xarelto, there may be an increased risk for clotting. However, when dexamethasone is co-administered with Xarelto, blood tests can be used monitor the efficacy of Xarelto to make sure that it is still working to prevent clotting.
I would encourage you to speak with your doctor about your concerns.
Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. S
Brief answer: There may be minor drug-drug interaction between Dexamethasone and Rivaroxaban (Xarelto), wherein the Dexamethasone may decrease the efficacy of Xarelto.
Detailed answer: Many drugs are metabolized (i.e., broken down) in the liver by a system of enzymes known as Cytochrome P450 (CYP450). Some drugs that are metabolized by this system can inhibit the metabolism of other drugs by this systems, while other drugs can enhance the metabolism of drugs by this system. Dexamethasone and Rivaroxaban (Xarelto) are both metabolized by the same CYP450 enzyme in the liver. Dexamethasone has been shown to increase the action of this enzyme so that the metabolism of other drugs is enhanced.
There is a possibility that Dexamethasone can increase the metabolism of Xarelto, thereby reducing the body's exposure to the drug and the its anticoagulant effect. Without the anti-coagulation effect of Xarelto, there may be an increased risk for clotting. However, when dexamethasone is co-administered with Xarelto, blood tests can be used monitor the efficacy of Xarelto to make sure that it is still working to prevent clotting.
I would encourage you to speak with your doctor about your concerns.
Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. S
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