Coadministration has not been studied but may increase edoxaban concentrations due to inhibition of P-gp by elbasvir. No a priori dose modification is recommended. A large, retrospective, multi-centre cohort study of patients coadministered HCV DAAs and DOACs, reported a low incidence of bleeding which was similar to historic controls of patients with liver disease on DOACs alone, providing reassurance that the interaction is unlikely to be clinically relevant in the majority of patients. Patients should be reminded to promptly report any signs of bleeding or bruising as with anyone who is prescribed DOACs. [Note: product labels state that edoxaban is contraindicated in patients with hepatic disease associated with coagulopathy and clinically relevant bleeding risk. It is not recommended in severe hepatic impairment and should be used with caution in patients with mild or moderate hepatic impairment.]