title: Development of Left Atrial Thrombus After Coadministration of Dabigatran Etexilate and Phenytoin.
abstract: Dabigatran etexilate is a substrate of the P-glycoprotein (adenosine triphosphate-binding cassette subfamily B member 1) transport system and is subject to interactions with medications that induce or inhibit this system. The clinical relevance of the interaction between dabigatran and phenytoin has not been well described. We report a case of left atrial thrombus in a patient receiving concomitant dabigatran etexilate and phenytoin, which is a P-glycoprotein inducer. This case illustrates the potential clinical significance of the interactions of medications that affect P-glycoprotein and dabigatran.
authors.affiliation: Department of Pharmacy, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada. Electronic address: nicole.peters@usask.ca.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hager
authors.affiliation: Department of Pharmacy, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bolt
authors.affiliation: Department of Pharmacy, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: Lori
authors.initials: L
authors.lastname: Albers
authors.affiliation: Department of Cardiology, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: Wladyslaw
authors.initials: W
authors.lastname: Wojcik
authors.affiliation: Department of Internal Medicine, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Duffy
authors.affiliation: Department of Pharmacy, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Semchuk
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects; D065694:Cytochrome P-450 CYP1A2 Inducers / Q000008:administration & dosage / Q000009:adverse effects; D000069604:Dabigatran / Q000008:administration & dosage / Q000009:adverse effects*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D017548:Echocardiography, Transesophageal; D006325:Heart Atria; D006331:Heart Diseases / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008297:Male; D010672:Phenytoin / Q000008:administration & dosage / Q000009:adverse effects*; D011655:Pulmonary Embolism / Q000188:drug therapy; D013927:Thrombosis / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000991:Antithrombins; D065694:Cytochrome P-450 CYP1A2 Inducers; D010672:Phenytoin; D000069604:Dabigatran