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1. Amiodarone, despite its side effect profile, is being prescribed to one-fifth of patients with AF on DOACs in Taiwan. Given the increased risk of bleeding with amiodarone and DOACs, this combination of medications should be used with extreme caution.
2. Atorvastatin, despite sharing metabolic pathways with DOACs, does not appear to increase risk of bleeding when used with DOACs and the two medications can probably safely be used together. It is unclear whether this conclusion about atorvastatin extends to other statins as other smaller studies have shown some data to the contrary.1
3. Fluconazole taken concurrenlty with a DOAC was associated wtih the highest bleeding risk (138.5 events per 1000 person-years). When –azole antifungals or antibiotics are being prescribed in someone on DOACs, it is always beneficial to consult with the pharmacist and proceed with caution.