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No dose adjustment for apixaban is required when coadministered with agents that are not strong inhibitors of both CYP3A4 and P-gp. For example, diltiazem (360 mg once a day), considered a moderate CYP3A4 and a weak P-gp inhibitor, led to a 1. Naproxen (500 mg, single dose) an inhibitor of P-gp but not an inhibitor of CYP3A4, led to a 1. Clarithromycin (500 mg, twice a day), an inhibitor of P-gp and a strong inhibitor of CYP3A4, led to a 1. Inducers of CYP3A4 and P-gp, methanabol 10 mg oral steroids $32.00 dianabol. Coadministration of apixaban with rifampicin, a strong inducer of both CYP3A4 and P-gp, led to an approximate 54% and 42% decrease in mean apixaban AUC and C max , respectively. The concomitant use of apixaban with other strong CYP3A4 and P-gp inducers (e. John’s Wort) may also lead to reduced apixaban plasma concentrations. 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