A Case Report of Rivaroxaban-Induced Urticaria and Angioedema With Possible Cross-Reaction to Dabigatran

Patil, Tanvi; Ikekwere, Christina

doi:10.14740/jmc3399

Cited by 4 publications

(6 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, possible cross-reactivity was previously noted between rivaroxaban and dabigatran. 9 However, mechanisms of this cross-reactivity are not yet fully understood. In contrast to this, dabigatran was identified to be safe for our patient through provocation tests.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Suspected Rivaroxaban-Induced Anaphylaxis Secondary to Ingestion of Rivaroxaban and Nimesulide Without Cross-Reactivity to Dabigatran – A Case Report

Gumbis,

Česnavičiūtė,

Didžiokaitė

et al. 2023

JAA

View full text Add to dashboard Cite

Here, we describe a case of anaphylaxis secondary to rivaroxaban in a 61-year-old woman 24 hours after orthopedic surgery. 10-15 minutes after ingestion of rivaroxaban and nimesulide, the patient's palms started itching, her face and lips swelled, her face flushed, she developed shortness of breath and subsequently lost consciousness. Serum tryptase levels at the time of the anaphylactic reaction were elevated, with subsequent measurement one month later returning a value within the normal range. Dabigatran and meloxicam were identified as suitable alternative drugs by oral provocation at an allergy clinic. Even though rivaroxaban rarely causes serious allergic reactions, when prescribing it, it is important to analyze patients' medical history for possible previously experienced drug-induced allergic reactions and to be aware of the risks of possible undesired drug interactions.

show abstract

Section: Discussionmentioning

confidence: 99%

“…(Table 1). [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Anaphylaxis secondary to rivaroxaban administration, is a rare condition, estimated to occur in about 0.01% of patients. 20 There are few previous cases of this condition in the literature.…”

Section: Introductionmentioning

confidence: 99%

Suspected Rivaroxaban-Induced Anaphylaxis Secondary to Ingestion of Rivaroxaban and Nimesulide Without Cross-Reactivity to Dabigatran – A Case Report

Gumbis,

Česnavičiūtė,

Didžiokaitė

et al. 2023

JAA

View full text Add to dashboard Cite

show abstract

“…Foods, medications, insect stings, and injections of allergen immunotherapy are the most common identifiable causes of anaphylaxis [ 5 , 6 ]. Since the introduction of DOACs to treat VTE and AF, several case reports have been published describing hypersensitivity to rivaroxaban, which is manifested in various forms of skin rashes [ 2 - 4 ]. Anaphylactic reaction following ingestion of rivaroxaban is extremely rare accounting for 0.01% of cases in one study [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the treatment of patients with venous thromboembolism (VTE) and atrial fibrillation (AF), direct oral anticoagulants (DOACs) have overshadowed warfarin due to less intracranial bleeding, simplified dosing, and predictable pharmacokinetics compared to warfarin [ 1 , 2 ]. Although, a growing number of reports of adverse drug reactions such as drug eruptions, urticaria, lichenoid eruption, and exanthematous rash have been published [ 2 - 4 ], anaphylaxis due to DOACs is extremely rare. Of 7111 participants in the rivaroxaban treatment arm of the ROCKET-AF study, anaphylaxis was found in 0.01% of cases [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Anaphylaxis following rivaroxaban ingestion: report of an extremely rare case

Khan

Sulaiman

2021

Pan Afr Med J

View full text Add to dashboard Cite

We reported an anaphylactic reaction following ingestion of rivaroxaban in a 48-years-old male, who was recently discharged from the hospital as a case of deep vein thrombosis. At home, the patient developed a diffuse itchy skin rash, shortness of breath, and vomiting 30 minutes after rivaroxaban ingestion. Emergency Medical Service found that the patient had severe dyspnea, low blood pressure, and decreased blood oxygen saturation. The patient was given oxygen, intramuscular epinephrine, intravenous hydrocortisone, diphenhydramine, salbutamol nebulizer, and was immediately transferred to the emergency department of Hamad General Hospital. Subcutaneous enoxaparin was initiated, while hydrocortisone and salbutamol nebulizer continued. On the next day, his vital signs had stabilized, and intravenous hydrocortisone was switched to prednisolone tablets, and salbutamol nebulizer was switched to budesonide/salmeterol inhaler, whereas enoxaparin was overlapped with warfarin. After achieving the target international normalized ratio (INR), enoxaparin was discontinued and the patient was discharged with significant clinical and laboratory improvement.

show abstract

“…11 Another recently published case report described rivaroxaban-induced urticaria and angioedema, with possible cross reactivity to dabigatran, manifested as rash in a 63-year-old male. 22 There is limited availability of information on the cross reactivity across different DOACs in the literature.…”

Section: Discussionmentioning

confidence: 99%

A rare case report of apixaban-induced lichenoid eruption

Patil

Hanna

Torre

2020

Therapeutic Advances in Drug Safety

Self Cite

View full text Add to dashboard Cite

With recent increase in the use of direct oral anticoagulants (DOACs), several new cases of adverse drug reactions (ADRs) have been identified in pharmacovigilance surveys. These ADRs can result in significant mortality and morbidity if not identified and treated promptly. It is important for physicians to recognize that immunologically mediated delayed hypersensitivity reactions, although rare in occurrence, can have significant impact on patient’s quality of life. To the best of our knowledge, we report the first case of lichenoid eruption associated with apixaban. We further provide evidence of tolerance to rivaroxaban in the same patient. Plain language summary Apixaban-induced lichenoid eruption Well documented case reports, although providing evidence of probable causal relationship between a drug and specific adverse drug reactions (ADRs), can increase awareness amongst clinicians treating patients with direct oral anticoagulants (DOACs), especially with its rapid utilization. Rare ADRs are difficult to detect as clinical trials of DOACs lacked enough patient sample, making post-marketing reporting of such events important so both patients and clinicians can be vigilant to help with prompt recognition of such symptoms. We report the first case of lichenoid eruption hypersensitivity reaction associated with apixaban in patient with tolerance to rivaroxaban.

show abstract

A Case Report of Rivaroxaban-Induced Urticaria and Angioedema With Possible Cross-Reaction to Dabigatran

Cited by 4 publications

References 26 publications

Suspected Rivaroxaban-Induced Anaphylaxis Secondary to Ingestion of Rivaroxaban and Nimesulide Without Cross-Reactivity to Dabigatran – A Case Report

Suspected Rivaroxaban-Induced Anaphylaxis Secondary to Ingestion of Rivaroxaban and Nimesulide Without Cross-Reactivity to Dabigatran – A Case Report

Anaphylaxis following rivaroxaban ingestion: report of an extremely rare case

A rare case report of apixaban-induced lichenoid eruption

Contact Info

Product

Resources

About