心房顫動（房顫）導致的卒中是其嚴重并發(fā)癥，非瓣膜性房顫導致腦梗死患者并發(fā)癲癇的風險比其他原因卒中患者更高，可能需要利伐沙班聯(lián)合抗癲癇藥物治療。新型口服抗凝藥物利伐沙班是口服直接Xa因子抑制劑，同時是CYP3A4和P-糖蛋白（P-gp）的底物，某些抗癲癇藥物對CYP3A4和/或P-gp有誘導作用，與利伐沙班合用，可使利伐沙班血藥濃度下降，血栓風險增加。對利伐沙班與丙戊酸鈉、卡馬西平、苯巴比妥、奧卡西平、左乙拉西坦以及其他抗癲癇藥物合用的相互作用進行綜述，并根據(jù)相關(guān)研究和病例報道給出推薦意見，為臨床合理用藥提供參考。

Stroke caused by atrial fibrillation is a serious complication. Patients with cerebral infarction due to non-valvular atrial fibrillation have a higher risk of epilepsy than patients with other causes of stroke. Treatment may require rivaroxaban combined with antiepileptic drugs. Rivaroxaban, a novel oral anticoagulant, is an oral direct factor Xa inhibitor and a substrate of CYP3A4 and P-glycoprotein (P-gp). Some antiepileptic drugs induce CYP3A4 and/or P-gp, and when combination with rivaroxaban, they can reduce rivaroxaban plasma concentrations and increase the risk of thrombosis. This article reviews the interaction of rivaroxaban combination with sodium valproate, carbamazepine, phenobarbital, oxcarbazepine, levetiracetam, and other antiepileptic drugs. Based on relevant studies and case reports, this paper provides recommendations for clinical rational drug use.

R971

天津市衛(wèi)生健康科技項目(KJ20143)