CYP3A4 and cancer: First, although DOACs have far fewer drug interactions than VKAs, it should be noted that rivaroxaban is metabolised by CYP3A4 enzymes.1 Patients with cancer, especially those with haematological cancer, are at high risk for opportunistic and fungal infections, for which they are often treated with CYP3A4 inhibitors or inducers.35 For this reason, prescription of rivaroxaban for the prevention of recurrent VTE in patients with cancer must be done carefully.1 This interaction does not play a role in LWMH treatment.