Association of Oral Anticoagulants and Verapamil or Diltiazem With Adverse Bleeding Events in Patients With Nonvalvular Atrial Fibrillation and Normal Kidney Function

Key Points Question What is the association of oral anticoagulants and verapamil hydrochloride or diltiazem hydrochloride with adverse bleeding events in patients with no kidney disease? Findings In this comparative effectiveness study using data from 48 442 patients, rates of bleeding were increased for patients receiving dabigatran etexilate with concomitant verapamil or diltiazem compared with those who were receiving concomitant amlodipine or metoprolol therapy. Other direct oral anticoagulants had no evidence of these drug-drug interactions. Meaning These findings suggest that prescribers may need to avoid P-glycoprotein–related drug-drug interactions with dabigatran regardless of kidney function.