To the Editor Among 91 330 patients with nonvalvular atrial fibrillation in Taiwan, the use of NOACs with concurrent amiodarone, fluconazole, rifampin, or phenytoin was associated with significantly increased risk of major bleeding.1 We are challenged to identify a biologically plausible explanation for the increased bleeding risk observed with phenytoin and rifampin.
Wang N, Giblin E, Rodgers JE. Drug Interactions With Non–Vitamin K Oral Anticoagulants. JAMA. 2018;319(8):830. doi:10.1001/jama.2017.20850
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